Key PAPR Selection Criteria

Key to insuring infection prevention is compliance. Without it the risks of infection significantly increase - an incident will occur; it is only a matter of when. PAPRs’ inherently higher filtration efficiencies (v. N95 Masks) provide the best protection. More importantly, they can lead to improved compliance versus N95s.

N95 Mask compliance is confounded by high percentages of HCWs not passing fit testing. These personnel need alternate protection or must be “managed around”. Many, who do use masks, re-use them, which is inappropriate. All this leads to cost and management burdens and poor compliance and safety.

Many who are unfamiliar with PAPRs perceive they are too costly, too difficult. In practice, they find PAPRs can be more comfortable, better for patient communication, quite easy to use, and more cost effective to implement. More user and patient friendly PAPRs enhance compliance, which leads to better infection control.

5 key parameters in evaluating PAPRs:

  1. Donning and doffing ease. How much time and paraphernalia – less is better.
  2. Comfort. Not restrictive to breathing with air-flow adjustment matching activity level; not hot to wear for long periods; not too close fitting to cause claustrophobic feelings; quiet so communication is not hampered.
  3. Bulk and weight - interference with maneuverability. Check for components extending away from the body for catching or snagging or that make moving around the patient’s bed and other equipment more difficult and a hazard.
  4. Universal between uses and between HCWs. Eliminate need for variable and unreliable results and the costs of fit testing; easily decontaminated between users so all HCWs can always be protected with minimal training and no fit testing.
  5. Ensure confidence in HCWs’ safety in hazardous environments. N95s are always suspect - one isn’t sure of the fit of the mask they don on any given day. Many PAPRs conceal filters and batteries - HCWs can’t tell, without disassembly, if filters are installed and installed properly, and checking and swapping a run down battery for one fully charged is a chore. These key components should be visible and easily assessable - they ensure proper air filtration and flow. Look for real time visual indicators that provide air flow and battery status continuously during use, unobtrusively. This adds confidence to convenience and comfort; together they facilitate compliance, and improve infection prevention.

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