When do I need to wear an N95?

N95 masks or PAPRs do not need to be worn for routine contact with a COVID-19 patient, as of the March 10 update to guidelines from the North Carolina Department of Health and Human Services (NCHHS) released on March 12. Regular facemasks are acceptable in most cases of routine contact. However, any Aerosol-Generating Procedures (airway management, nebulizer administration, intubation, deep suctioning, cardiac arrest resuscitation, etc) require their use.

Other aerosol considerations (suggestions from March 20 SCCM webinar)

-clamp ETT when taking a patient on/off the vent

-ensure ventilator is on standby while not using/transferring/coding

Mask use considerations from the CDC, and the potential for additional risk with non-standard use

-Reuse: using the same N95 for multiple encounters with different patients, but donning and doffing between each patient encounter. Not recommended in the case of COVID-19 or where fomite transmission is a concern.

-Extended Use: using the same N95 for multiple encounters with different patients, without removing the respirator between patient encounters. Favored over reuse as it involves less touching/risk of contact transmission. Should be 'limited

-Doubling: wearing a regular facemask over your N95 respirator. Keep the N95 on throughout the day (less wear and tear with fewer on/off changes) and use the regular facemask as a disposable mask.