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Review
. 2014 Fall;50(3):87-90.

To PAPR or not to PAPR?

Vanessa Roberts  1
Affiliations
Review

To PAPR or not to PAPR?

Vanessa Roberts. Can J Respir Ther. 2014 Fall.

Abstract
in English, French

The present outbreak of Ebola has health care professionals seeking guidance on isolation precautions for routine care and aerosol-generating procedures (AGPs). The most recent guidelines state that during AGPs, health care professionals should wear respiratory protection at least as protective as a National Institute for Occupational Safety and Health-certified fit tested N95 filtering face piece respirator or higher; for example, a powered air-purifying respirator (PAPR). The present review discusses the advantages and disadvantages of using a PAPR versus an N95 mask, and relates the experience of the Jewish General Hospital (Montreal, Quebec) of PAPR policy implementation. Training programs on proper donning and doffing of personal protective equipment and quality control systems need to be in place. Respiratory therapists are frontline during AGPs and need to be active in the decision making of the type of equipment chosen to protect them.

La présente éclosion du virus Ebola incite les professionnels de la santé à chercher des conseils sur les précautions en matière d’isolement dans les soins habituels et les interventions produisant des aérosols (IPA). D’après les lignes directrices les plus récentes, pendant les IPA, les professionnels de la santé devraient porter un dispositif de protection des voies respiratoires qui leur procurera une barrière au moins aussi efficace qu’un masque N95 ayant fait l’objet d’un essai d’ajustement certifié par le National Institute for Occupational Safety and Health, tel qu’un appareil respiratoire à adduction d’air (ARAA). La présente analyse traite des avantages et des inconvénients de l’ARAA par rapport au masque N95 et rend compte de l’expérience de l’Hôpital général juif de Montréal, au Québec, qui a adopté une politique d’utilisation de l’ARAA. Il faut adopter des programmes de formation sur la mise en place et le retrait convenables du dispositif de protection personnelle ainsi qu’un système de contrôle de la qualité. Les inhalothérapeutes sont en première ligne pendant les IPA et doivent participer à la prise de décision sur le type de matériel retenu pour les protéger.

Keywords: Aerosol-generating procedures; Ebola; Infection control; Personal protective equipment; Power air-purifying respirator.

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Figures

Figure 1)
Figure 1)
Examples of National Institute for Occupational Safety and Health-certified N95 masks, courtesy of 3M (USA) (11) and Moldex (USA) (12)
Figure 2)
Figure 2)
3M Air-Mate (3M, USA) belt-mounted battery operated respirator with disposable black tubing (left) and double-shrouded hood (right). Reproduced with permission from Powered Air, Supplied Air & Welding Solutions 3M Personal Safety Division (13)
Figure 3)
Figure 3)
3M Air-Mate (3M, USA) rechargeable battery, high-efficency particulate air filter (top left), black tube connecting to the powered air-purifying respirator and the blower (bottom left), manufacturer’s specifications (bottom right). Reproduced with permission from Powered Air, Supplied Air & Welding Solutions 3M Personal Safety Division (13)
Figure 4)
Figure 4)
3M Air-Mate (3M, USA) black tube attached to the hood and the blower (left), example of hood placed over the face (right). Reproduced with permission from Powered Air, Supplied Air & Welding Solutions 3M Personal Safety Division (13)
See this image and copyright information in PMC

References

    1. Siegel JD, Rhinehart E, Jackson M, Chiarello L, the Healthcare Infection Control Practices Advisory Committee . CDC 2007 guideline for isolation precautions: Preventing transmission of infectious agents in the healthcare setting. Atlanta: Centers for Disease Control and Prevention; - PMC - PubMed
    1. The Public Health Agency of Canada. < www.phac-aspc.gc.ca/id-mi/vhf-fvh/ebola-eng.php> (Accessed April 30, 2014)
    1. COCA Calls “What U.S. Hospitals Need to Know to Prepare for Ebola Virus Disease”. < http://emergency.cdc.gov/coca/calls/2014/callinfo_080514.asp> (Accessed August 5, 2014)
    1. Infection Prevention and Control Recommendations for hospitalized patients with known or suspected Ebola Hemorrhagic Fever in U.S. < www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendatio...> (Accessed August 12, 2014)
    1. World Health Organization Interim Infection Control Recommendations for Care of Patients with Suspected or Confirmed Filovirus (Ebola, Marburg) Haemorrhagic Fever. Mar, 2008. < www.whoint/csr/bioriskreduction/filovirus_infection_control/en/> (Accessed April 30, 2014).

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