AHA urges CDC to revise N95 guidelines for H1N1

By: September 17th, 2009 Email This Post Print This Post

It seems even the IOM recommendations couldn’t put an end to the respiratory protection debate.

On Tuesday American Hospital Association (AHA) urged the CDC to to revise its hospital infection control guidelines, specifically regarding N95s. The association advised the CDC to consider the most recent evidence on how the disease is transmitted and the limited supply of N95 respirators, according to its Web site.

In a letter to the CDC’s National Institute for Occupational Safety and Health, AHA recommended using surgical masks for direct patient contact, and reserving N95s for aerosol-generating procedures.

“Current CDC guidance, issued this past Spring before the severity or mechanism of transmission was fully understood, conservatively recommends the use of N-95 (or higher) respirators for routine patient care,” the letter states. “However more recent data suggests that the virus has not changed to become more severe and studies suggest that it transmits much the same way as seasonal influenza.”

The letter also notes that the CDC’s own comittee Healthcare Infection Control Practices Committee (HICPAC) previously recommended the use of surgical masks when treating patients with suspected H1N1, and that the IOM study did not take into account, “logisital or economical considersations.”

The AHA letter also mentions physician offices specifically:

“Given that physician practices are unfamiliar with the use of fit-tested N-95 respirators and the difficultly they will face in obtaining adequate supplies, we are concerned that this would be another disincentive for physicians to treat patients with flu-like symptoms in their offices, resulting in a further surge of individuals being inappropriately sent to hospital emergency departments for care.”

(For those of you looking for help, you can browse through our fit testing training blog posts for assistance).

You can expect a final decision from the CDC by Ocotober. Until then, the debate rages on.

Comments

By Kimberly McHatton on September 22nd, 2009 at 10:17 am

Should patients with ILI be placed in “droplet precautions” vs “airborne precautions”?

Here is what the current CDC guideline says:

Isolation precautions
All healthcare personnel who enter the patient’s room should take standard and contact precautions plus eye protection should be used for all patient care activities for patients being evaluated or in isolation for novel H1N1 . Maintain adherence to hand hygiene by washing with soap and water or using alcohol-based hand sanitizer immediately after removing gloves and other equipment and after any contact with respiratory secretions. Nonsterile gloves and gowns along with eye protection should be donned when entering a patient’s room. (See Personal Protective Equipment (PPE) in Healthcare Settings)

Respiratory protection: All healthcare personnel who enter the rooms of patients in isolation with confirmed, suspected, or probable novel H1N1 influenza should wear a fit-tested disposable N95 respirator or better. Respiratory protection should be donned when entering a patient’s room.

By Michelle Monceaux, RN, IC on April 6th, 2011 at 9:46 am

Can you tell me how often we should be fit testing employees for the N95 respirator? We do this on hire and would like to know the requirement for annual testing.

By David LaHoda on April 6th, 2011 at 10:01 am

OSHA’s Respiratory Protection standard, 1910.134(f)(2), requires employers to annually fit test employees who are required to where respirators. This includes disposable N95s. The standard also requires fit testing when circumstances occur that might affect proper fit or protection. For details see Ask the expert: Where does it say to fit test annually?

 

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