Extended use: Practice of wearing the same N95 respirator for repeated encounters with several patients, without removing the respirator between the encounters.
It is implemented when multiple patients are infected, and patients are placed together in dedicated waiting rooms, clinics or hospital units. Eye protection may be left in place with the N95 respirator for extended use
Reuse: The practice of using the same N95 respirator for multiple encounters with patients but removing it (‘doffing’) between at least some of the encounters.
The N95 respirator is stored in between encounters and reused. Face shields will be dedicated for use by individual healthcare personnel. Disinfection of the face shield will be required between uses.
Guiding Principles
Extended use is preferred over re-use. It is appropriate for team members following this extended use guidance to remove PPE during breaks and lunch periods.
Item that are approved for reuse can be removed, stored and reused following break/meals.
Facemasks, N95 respirators, and eye protection can be re-used in a careful and limited way during periods of short supply.
Facemasks that fasten to the provider via ties may not be able to be undone without tearing and should be considered only for extended use, rather than re-use.
Guidance is for reuse by a single person (no sharing). This principle applies to Facemask & N95 respirators
Disposable N95 respirators may be re-used or worn for extended use, as long as they are covered by face shield during aerosol-generating procedure, or have reached the end of their use by being visibly soiled, obviously damaged or wet.
Limit room traffic where possible by ensuring that only those essential for patient care enter the room; strategies include bundling of care, limiting or avoiding bedside clinical teaching, limiting operating room traffic, and use of telemedicine where possible Applicability These guidelines apply to all health care personnel (HCPs) who need to wear respiratory protection during patient care or as a requirement of their work responsibilities.
Guidance for Reuse N95
All supplies of N95 respirators will be stored in locked or secured, designated areas and will be issued to staff with a paper bag or container that allows breathability.
Once the disposable N95 respirator is donned, a full-face shield should be applied over the N95 respirator.
Perform hand hygiene and remove the face shield. The front is potentially contaminated, so remove carefully by bending forward and using the elastic band.
Use a germicidal wipe to prepare a surface upon which the face shield will be placed then remove face shield and disinfect before placing it on the prepared surface. Face shield is disinfected using a germicidal wipe
Storage of Previously Worn N95 Respirators: After removing N95 respirators, visually inspect and discard if visibly soiled, obvious damage or wet. The N95 respirators should be stored in a well-ventilated container (i.e., paper bag) with username & date.
A disposable N95 respirator can be worn for several hours and multiple shifts if not wet or damaged, and not involved in an aerosol-generating procedure unless it is covered by face shield.
References Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH)
https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.htmlhttps://www.cdc.gov/niosh/topics/hcwcontrols/pandemic-planning.html This document was adapted from Guidance for Extended Use and Reuse of Facemasks, Respirators, and Protective Eyewear, University of Maryland/Nebraska Medicine
Compiled By Dr. KK Aggarwal
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