Particulate filter respirators (P2/N95 respirators)
Particulate filter respirators (PFR) are designed to reduce the wearer’s respiratory exposure to airborne contaminants such as particles, gases or vapours. P2/N95 respirators are types of PFR.
PFR are appropriate for use for respiratory protection as part of the personal protective equipment (PPE) required for airborne precautions applied in healthcare facilities (for both clinical and non-clinical healthcare workers).
PFR are also appropriate as part of the PPE required for all health care workers involved in aerosol-generating procedures when a patient is confirmed or suspected of having a disease that may be transmitted via the droplet or airborne route (including COVID-19).
Aerosol generating procedures include (list is not intended to be exhaustive):
- endotracheal intubation and extubation
- nebulised medication administration
- high-flow nasal oxygen
- airway suctioning
- bronchoscopy
- diagnostic sputum induction
- non-invasive ventilation
- high frequency oscillatory ventilation
- surgery involving the upper or lower respiratory tract.
A further list of potentially aerosol-generating procedures can be found in the Queensland Health infection prevention and control guidelines for the management of COVID-19 in healthcare settings
For information on powered air-purifying respirators (PAPR) refer to Queensland Health Guideline for CleanSpace HALO
Fit checking
Fit checking must be done each time a PFR is put on to ensure that the respirator is properly applied, a good seal is achieved over the bridge of the nose and mouth, and there are no gaps between the respirator and face. Fit checking is the appropriate minimum standard at the point of use for healthcare workers using PFR.
No clinical activity should be undertaken until a satisfactory fit has been achieved.
Healthcare workers must be trained in the correct use of personal protective equipment (PPE), including fit checking of PFR and safe fitting and removal of PPE. Refer to the following resources:
Fit check steps
Follow these steps for a PFR respirator fit check:
- Perform hand hygiene.
- Select correctly fitting PFR, holding outer edges, separate edges and straps.
- Slightly bend nosepiece to form a gentle curve.
- Separate the headbands and position PFR under chin with nosepiece up.
- Pull headbands up over head, ensuring top strap is resting high at back of head and bottom strap is positioned below ears.
- Use fingertips to mold nosepiece and ensure good facial fit around face, cheeks and bridge of nose.
- Positive seal check – exhale sharply. A positive pressure inside PFR = no leakage. If leaking, adjust position and/or tension straps.
- Negative seal check – inhale deeply. If no leakage, negative pressure will make PFR cling to face, readjust if required.
Several companies supply PFR for Queensland Health. For information about fit checking specific respirators please refer to the product information from the relevant supplier.
An adequate seal may be difficult, or impossible, to achieve with facial hair.
If an adequate seal cannot be achieved, healthcare workers should not proceed with clinical care and should speak to their line manager.
Maintaining the fit and protection from airborne particles
It is essential that the fit of the PFR is not compromised once the fit check has been successfully completed.
Do not
- touch the PFR while it is being worn
- reapply the PFR after it has been removed – don new PFR if required
- leave the PFR dangling around the neck.
Do
- change the PFR when it becomes moist
- wash hands after a used PFR is touched or disposed of
- leave the patient room/care area before removing the PFR
- dispose of used PFR in a closed receptacle.
Fit testing
Fit testing is a validated method to determine whether a specific make, model and size of respirator achieves an adequate seal on an individual’s face.
An inadequate fit reduces the protection provided and can put the healthcare worker at risk. Fit testing should be carried out before wearing a PFR for the first time.
Fit testing also provides an opportunity to ensure healthcare workers are properly trained in the correct use of the PFR and are aware of how to perform a fit check.
All healthcare facilities should undertake fit testing as part of a respiratory protection program in line with the Queensland Health Fit Testing of P2/N95 respirators in respiratory protection programs guidance (PDF 441 kB)