Respiratory Protection for Ebola

Respiratory Protection for Ebola

As part of the updated guidance for personal protective equipment or PPE for healthcare personnel caring for patients with Ebola virus disease in US hospitals, CDC recommends that all healthcare personnel who are caring for patients with Ebola wear either a powered air-purifying respirator, commonly called a PAPR, or a NIOSH-certified fit- tested N95 or higher respirator. It’s important to understand the rationale behind this recommendation. Ebola is not transmitted via an airborne route. Rather, Ebola is transmitted through contact with the blood or body fluids of an infected patient. Healthcare workers have safely cared for patients with Ebola over several decades wearing surgical masks instead of respirators. However, caring for patients with Ebola in US hospitals is likely to include elements of invasive medical care not routinely used in field settings, and the need for such procedures is hard to predict. As a result, a sudden need might arise to perform an aerosol- generating procedure, for example an intubation. PPE worn in caring for patients with Ebola takes several minutes to put on and take off and we know that rushing can lead to mistakes. Therefore, the guidance is designed so that healthcare personnel entering the room will be protected, even in the event that an aerosol-generating procedure needs to be performed. Single-use N95 or higher respirators should be used in combination with a single-use, disposable surgical hood that extends to the shoulders and a single-use, disposable full face shield. If N95 respirators are used, healthcare workers should be observed during all interactions with the patient to make sure they don’t inadvertently touch their faces under the face shield during patient care. If PAPRs are being used, select one with a full face shield, helmet, or headpiece. Any reusable helmet or headpiece must be covered with a single-use, disposable hood that extends to the shoulders and fully covers the neck and is compatible with the selected PAPR. The healthcare facility should follow the manufacturer’s instructions for cleaning and disinfecting all reusable components and, based on those instructions, should develop facility protocols that include designating responsible personnel whose job it is to ensure that the equipment is appropriately reprocessed and that the batteries are fully charged before use. Both N-95 or higher respirators and PAPRs have been used to safely care for patients with Ebola in US hospitals. Both N-95 respirators and PAPRs are used every day in US hospitals to safely care for patients who have diseases that are transmitted by an airborne route, like tuberculosis. And both N-95 respirators and PAPRs are recommended to protect healthcare personnel who are performing aerosol generating procedures on patients with diseases that are transmitted by an airborne route, like tuberculosis. Regardless of the form of respiratory protection being used – a NIOSH- certified PAPR or a NIOSH-certified fit-tested disposable N95 respirator – make sure you’re in compliance with all elements of the OSHA Respiratory Protection Standard, including fit testing, medical evaluation, and training of healthcare workers. Most importantly, make sure that you are trained on and practice with all equipment before you use it, and that you have a trained observer to make sure you put on and take off equipment correctly.

3 Replies to “Respiratory Protection for Ebola”

  1. You can only get ebola through direct contact through bodily fluids, and it is not airborne.*

    *Make sure to wear a n95 respirator though.

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