Choosing the right mask

Choosing the right mask for each surgical and procedural situation has never been more important, for three key reasons:

1. The risk of facial exposure to blood, bodily fluids, secretions and excretions.
2. Today’s clinical emphasis on reducing healthcare-associated infections.
3. The renewed focus on patient and staff safety, as well as quality initiatives. A catalyst
4. for this effort has been the rise of new pathogens and antibiotic-resistant bacteria (the “super bugs”).

To help address these challenges, the purpose of masks has evolved over time. Originally, they were developed to minimize the risk of patient wound infection due to microorganisms transmitted from clinicians via coughs, sneezes and droplets.

Today’s masks are intended to protect both patients and clinicians from several risks, including:

• New and drug-resistant pathogens transmitted by patient blood or other bodily fluids.
• Smoke plume that can contain toxic chemicals and other irritants.
• Particulate contaminants that include dust expelled by high-speed devices.

In particular, one of the exposure risks is to blood borne pathogens, including HIV, HBV, HVC and others. This risk impacts 5.6 million healthcare workers,² and it’s one of the top five causes of injury among them.³

In fact, blood or blood products are involved in 63 percent of exposure incidents.⁴ Twenty-six percent of OR blood exposures are to the heads and necks of scrubbed personnel,⁵ while 59 percent of blood and bodily fluid exposures are among experienced OR doctors.⁶ Seventeen percent of blood exposures occur with circulating personnel outside the sterile field.⁷ Yet, 76 percent of OR directors make procedure instead of surgical masks available for OR staff.⁸

According to a recent survey conducted among hundreds of OR nurses, non-OR nurses, infection control practitioners and other clinicians, the most influential factor when selecting a mask is simply what’s available at the facility. Following that are training, comfort and habit. Only 44 percent of survey respondents ranked ASTM standards as an influencer—and that leads to a significant safety issue.

According to the same study, 75 percent of participants use the incorrect PPE for the procedure or setting.⁹ That may lead not only to staff and patient health risks, but also regulatory citations and fines. Following ASTM standards would help solve the problem, but awareness of them is low:

• 48 percent of OR staff are unaware of ASTM standards and the different levels of protection.¹⁰
• 57 percent of face mask units sold in 2016 did not have or claim an ASTM rating.¹¹

While 84 percent of facilities surveyed have a mask selection protocol, more than half of clinicians said they use their medical judgment when selecting a mask—even if that falls outside the protocol. The encouraging news is that 95 percent of those surveyed said they would change their selection if they had higher awareness of ASTM standards.