All personnel conducting fit testing are expected to be familiar with the information in this entry as well as the information provided in the additional resources section following.
Dayton MMRS has long recommended use of Qualitative Fit Testing (QNFT) for N-95 Respirator Masks procedures (as opposed to Quantitative), in part because quantitative fit testing of disposable N-95 Masks (using equipment such as a PortaCount) is a destructive test, requiring that a hole be punched in the mask. With QNFT, the person can keep the mask for use on a run. With 4,000 EMS personnel in our region, Qualitative fit-testing saves a lot of masks.
Have each person who is fit-tested, use a soft-tipped pen (e.g., a “Sharpie”) to write the person’s name on the mask.
They can keep that mask and use it “in the real world” to care for a patient when indicated. Document that the patient received a mask, including make and model. We also continue to recommend use of renewable PPE resources such as PAPRs when possible. Some PAPRs provide a higher protective factor, and PAPRs reduce respiratory work for the wearer.
Also, remind your personnel to place a surgical mask (not an N-95) on the patient.
According to OSHA, NIOSH, CDC, and the World Health Organization (WHO), properly fitted and worn N-95 Masks protect against Avian Influenza, SARS, and multiple other agents. Dayton MMRS recommends that partner agencies maintain an appropriate cache of Respiratory PPE.
We offer the following recommendations concerning N-95s:
- Store and maintain N-95s according to manufacturer’s recommendations
- Annually fit-test personnel who will utilize the N-95’s according to current standards. Employees who are to wear N-95 Masks must be trained and fit-tested, and have an annual respiratory assessment. In one study, investigators found that only 24% (129 of 538) of participants wore the devices properly. N-95’s can legitimately be fit-tested using non-destructive, quantitative tests (i.e., formalized “smell” testing)
- Ensure that only providers with appropriate training utilize N-95’s
- Promulgate an SOP, SOG, or other materials for your organization, requiring appropriate utilization of the N-95’s by your agency’s personnel.
Additional PPE Fitting Resources
CDC Frequently Asked Questions about Personal Protective Equipment (new window)
3M Instructional video on the Qualitative Fit Test process (new window)
Fitting Instructions for the 3M Respirator (new window)
ODH & OHA Immediate Actions for the Conservation of Personal Protective Equipment (new window)
Release of Stockpiled N95 Filtering Facepiece Respirators Beyond the Manufacturer-Designated Shelf Life: Considerations for the COVID-19 Response: https://www.cdc.gov/coronavirus/2019-ncov/release-stockpiled-N95.html
Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html
Strategies for Optimizing the Supply of N95 Respirators: Crisis/Alternate Strategies – Crisis/Alternate Strategies https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/crisis-alternate-strategies.html