Surgical Mask or Respirator?
Surgical Mask or Respirator?
Here are excerpts of the Centers for Disease Control and Prevention’s (CDC) disease-specific guidance on whether health care workers should use surgical masks or respirators:
Influenza:
A surgical or procedure mask should be worn by health care personnel who are in close contact (i.e., within 3 feet) with a patient who has symptoms of a respiratory infection, particularly if fever is present, as recommended for standard and droplet precautions. These precautions should be maintained until the patient has been determined to be noninfectious or for the duration recommended for the specific infectious agent.
(Source: CDC. Guidelines & Recommendations: 2004-05: Interim Guidance for the Use of Masks to Control Influenza Transmission. Nov. 18, 2004. Web site: www.cdc.gov/flu/professionals/infection control/maskguidance.htm.)
Avian influenza:
Given the uncertainty about the exact modes by which avian influenza may first transmit between humans additional precautions for health care workers involved in the care of patients with documented or suspected avian influenza may be prudent. Use a fit-tested respirator, at least as protective as a National Institute of Occupational Safety and Health (NIOSH)-approved N95 filtering facepiece (i.e., disposable) respirator, when entering the room.
(Source: CDC. Interim Recommendations for Infection Control in Health Care Facilities Caring for Patients with Known or Suspected Avian Influenza. Web site: www.cdc.gov/flu/avian/professional/infect-control.htm.)
Pertussis:
Because droplet transmission of pertussis can occur at the first contact with an ill patient, HCWs and hospital infection control services should take measures to prevent hospital transmission. Many nosocomial outbreaks might be prevented by HCWs’ observing droplet precautions (i.e., wearing procedural or surgical masks and hand washing).
(Source: CDC. Outbreaks of pertussis-associated with hospitals — Kentucky, Pennsylvania, and Oregon, 2003. MMWR 2005; 54:67-71.)
Tuberculosis:
Personal respiratory protection should be used by:
- People entering rooms in which patients with known or suspected infectious TB are being isolated.
- People present during cough-inducing or aerosol-generating procedures performed on such patients.
- People in other settings where administrative and engineering controls are not likely to protect them from inhaling infectious airborne droplet nuclei.
The facility’s risk assessment may identify a limited number of selected settings (e.g., bronchoscopy performed on patients suspected of having TB or autopsy performed on deceased persons suspected of having had active TB at the time of death) where the estimated risk for transmission of M. tuberculosis may be such that a level of respiratory protection exceeding the standard performance criteria is appropriate. In such circumstances, a level of respiratory protection exceeding the standard criteria and compatible with patient care delivery (e.g., more protective negative-pressure respirators; powered air-purifying particulate respirators [PAPRs]; or positive-pressure air-line, half-mask respirators) should be provided by employers to HCWs who are exposed to M. tuberculosis.
(Source: CDC. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health care facilities, 1994. MMWR 1994; 43:1-132.)
Plague:
Droplet precautions require health care providers and others to wear a surgical-type mask when within 3 feet of the infected patient. Based on local policy, some health care facilities require a mask to be worn to enter the room of a patient on droplet precautions. Droplet precautions should be maintained until patient has completed 72 hours of antimicrobial therapy. Patients suspected or confirmed to have pneumonic plague require droplet precautions.
(Source: CDC, Association for Professionals in Infection Control and Epidemiology Bioterrorism Working Group. Bioterrorism Readiness Plan: A Template for Health Care Facilities. 1999. Web site: (Source: CDC, Association for Professionals in Infection Control and Epidemiology Bioterrorism Working Group. Bioterrorism Readiness Plan: A Template for Health Care Facilities. 1999. Web site: www.cdc.gov/ncidod/hip/Bio/13apr99APIC-CDCBioterrorism.PDF.)
Smallpox:
For patients with suspected or confirmed smallpox, both airborne and contact precautions should be used in addition to standard precautions. Airborne precautions require health care providers and others to wear respiratory protection when entering the patient room. (Appropriate respiratory protection is based on facility selection policy; must meet the minimal NIOSH standard for particulate respirators, N95.)
(Source: CDC, Association for Professionals in Infection Control and Epidemiology Bioterrorism Working Group. Bioterrorism Readiness Plan: A Template for Health Care Facilities. 1999. Web site: www.cdc.gov/ncidod/hip/Bio/13apr99APIC-CDCBioterrorism.PDF.)
Here are excerpts of the Centers for Disease Control and Preventions (CDC) disease-specific guidance on whether health care workers should use surgical masks or respirators.Subscribe Now for Access
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