N95 respirator masks may not provide adequate protection during chest compressions, even when resuscitators have passed quantitative fit testing.

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• Sung Yeon Hwang, Hee Yoon, Aerin Yoon, Taerim Kim, Guntak Lee, Kwang Yul Jung, Joo Hyun Park, Tae Gun Shin, Won Chul Cha, Min Seob Sim, and Seonwoo Kim.
• Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
• Am J Emerg Med. 2020 Jan 1; 38 (1): 12-17.

BackgroundN95 filtering facepiece respirators (N95 respirators) may not provide adequate protection against respiratory infections during chest compression due to inappropriate fitting.MethodsThis was a single-center simulation study performed from December 1, 2016, to December 31, 2016. Each participant underwent quantitative fit test (QNFT) of N95 respirators according to the Occupational Safety and Health Administration protocol. Adequacy of respirator fit was represented by the fit factor (FF), which is calculated as the number of ambient particles divided by the number inside the respirator. We divided all participants into the group that passed the overall fit test but failed at least one individual exercise (partially passed group [PPG]) and the group that passed all exercises (all passed group [APG]). Then, the participants performed three sessions of continuous chest compressions, each with a duration of 2 min, while undergoing real-time fit testing. The primary outcome was any failure (FF < 100) of the fit test during the three bouts of chest compression.ResultsForty-four participants passed the QNFT. Overall, 73% (n = 32) of the participants failed at least one of the three sessions of chest compression; the number of participants who failed was significantly higher in the PPG than in the APG (94% vs. 61%; p = 0.02). Approximately 18% (n = 8) of the participants experienced mask fit failures, such as strap slipping.ConclusionsEven if the participants passed the QNFT, the N95 respirator did not provide adequate protection against respiratory infections during chest compression.Copyright © 2019 Elsevier Inc. All rights reserved.

This article appears in the collection: Anaesthesiology, Personal Protective Equipment (PPE) and COVID.

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