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					                         Infection Control Advice
                      Fit Testing of P2 (N95) Masks
You should refer to manufactures’ recommendations regarding fit testing if a particular fit test
is required. The most common fit test is a “Qualitative Fit Test” and that is the test described
below. The qualitative fit test relies on a subjective sensation (taste & smell). A fit test kit has
 all the necessary equipment.

      If the person has facial hair that disrupts the fit of a P2 mask, then they cannot be fitted
         (some moustaches and short goatees may not interfere with fit)
      If the person is pregnant, consult her healthcare provider before fit testing
      If the person has asthma, a medical opinion should be sort
      Explain to the person that the process may be “claustrophobic”

Testing involves two parts
   1. Threshold Check Procedure
            a. This checks the person can taste the test solution (bitter or sweet) and at what
                point they can taste it.
   2. Fit Test Procedure
            a. This checks the fit of the P2 mask

Threshold Check Procedure
  1. Put hood on the subject
  2. Ask the subject to breathe through their mouth with their tongue extended
  3. Put nebuliser containing threshold solution into the hole at the front of the hood
  4. Press bulb of nebuliser up to 10 times asking the person to tell you when they first taste
      the solution
          a. If the person does not taste the solution, repeat the above up to three more
              times, stopping between times.
          b. If the person cannot taste the test solution after this, the qualitative test is not
              suitable for them
  5. Make record of when the person can taste the solution
               No. of nebulisers administered         Record Threshold
               0-10                                   10
               10-20                                  20
               20-30                                  30

   6. Remove hood, offer glass of water
   7. Wait 15mins or until they cannot “taste” the solution
   8. Wipe hood with a detergent wipe to remove residual solution

INSTRUCTION FOR PUTTING ON P2 (N95) Masks

1. Separate the edges of the p2 (N95) to fully open it.
2. Slightly bend the nose wire to form a gentle curve.
3. Hold the respirator upside down to expose the two headbands.
4. Using your index fingers and thumbs, separate the two headbands.
5. While holding the headbands with your index fingers and thumbs, cup the respirator
under your chin.
6. Pull the headbands up over your head.
7. Release the lower headband from your thumbs and position it at the base of your neck.
8. Position the remaining headband on the crown of your head.
9. Conform the nosepiece across the bridge of your nose by firmly pressing down with your
fingers.
10. Continue to adjust the respirator and secure the edges until you feel you have achieved a
good facial fit.

Now, perform a “Fit Check”.

FIT CHECK PROCEDURE

To ensure P2 (N95) Particulate Filter Respirators are providing the intended level of
protection, a “Fit Check” must be conducted each and every time they are worn.
To “Fit Check” a respirator, the wearer should forcefully inhale and exhale several times.
The respirator should collapse slightly upon inhaling and expand upon exhaling. The wearer
should not feel any air leaking between his/her face and the respirator.
This is the sign of a good facial fit and a successful Fit Check.
FIT TESTING PROTOCOL

Prepare Equipment
     Check and familiarise yourself with the fit test box and contents

Prepare the Person
     Explain the procedure and its purpose
     Ensure the person has not eaten / drunk, chewed gum or smoked in the past 15
       minutes

Fit Test Procedure

Talk the subject through the following exercise whilst carrying out tester instructions
simultaneously

SUBJECT                                       TESTER
Must complete each task for 60 seconds        Must time 60 seconds for each task
1. Breathe normally                           1. Depress nebuliser ½ the threshold
                                                 amount every 30 seconds (ie.
                                                 Threshold = 10; press nebuliser 5
                                                 times)
2. Deep breathe through mouth                 2. Depress nebuliser ½ the threshold
                                                 amount every 30 seconds
3. Turn head to Left and Right; pause to      3. Depress nebuliser ½ the threshold
   breath at each side                           amount every 30 seconds
4. Move head up and down; pause to            4. Depress nebuliser ½ the threshold
   breathe at each angle                         amount every 30 seconds
5. Read out aloud the “Hand Hygiene           5. Depress nebuliser ½ the threshold
   Prose” (provided below)                       amount every 30 seconds
6. Breathe normally                           6. Depress nebuliser ½ the threshold
                                                 amount every 30 seconds
         Does the subject TASTE the test solution during the exercises?


                   YES                                           NO
   STOP the test                                An acceptable fit has been established.
   Start again with different size / brand of
                                                   Document on “fit-test” record
   mask
   Wait 15 minutes before retesting
   If still tasting the test solution, use an
   alternative solution

Cleaning Fit Test Equipment

    Nebulisers must be thoroughly cleaned with warm water and neutral detergent at
     completion of the fit testing procedure.
    Ensure the black “o-ring”, nebuliser bulb and inner piece are thoroughly cleaned – if
     test solution particles are left to dry they will obstruct the nebuliser

The “Hand Hygiene Prose”
    Effective Hand Hygiene is the single most important strategy in preventing health care
      associated infections.
    Hand Hygiene is a general term applying to the use of soap/solution (non-antimicrobial
      or antimicrobial) and water, or a waterless antimicrobial agent to the surface of the
      hands.
    Hand hygiene practices have been universally poor among health care workers.
    Use an alcohol based hand rub for all clinical situations where hands are visibly clean.
    Wash with soap and water when visibly dirty or contaminated with blood or other
      body fluids, or if exposure to potential spore forming organisms is strongly suspected
      or proven, or after using the bathroom.
                                     SAMPLE - Qualitative Fit Test Record
Subject   Area/   Threshold Test          Comment    Fit test             Recommended Mask             Fit        Re-fit
Name      Dept              Solution      ie. tape                                                     Tester     required
                                                     Pass/Fail               Brand / Size
                                          required                                                     Initials
                            Saccharin /                                                                           Date/time
                            Bitrex

                                                                 Brand      Brand    Brand    Brand
                                                                 Size S     Size M   Size S   Size M

				
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