September 4th, 2009

For Suspected H1N1, Get Out the N95 Masks?

So says the Institute of Medicine’s recommendations for protection of health care workers:

Healthcare workers (including those in non-hospital settings) who are in close contact with individuals with nH1N1 influenza or influenza-like illnesses should use fit-tested N95 respirators … Employers should ensure that the use and fit testing of N95 respirators be conducted in accordance with OSHA regulations.

Every so often — well, more like constantly — my wife (the primary care pediatrician in full-time practice) reminds me what life is like seeing patients outside of a tertiary care, academic medical setting.

Her response to this recommendation to use N95 respirators for evaluation of all “influenza-like illness”?

Amazement, incredulity, bafflement, dismay.  Seeing as waiting rooms of pediatricians’ offices in the winter are filled with kids with cough, runny nose, and fever, I can certainly understand her response.  If these guidelines were followed literally, everyone in these offices would have to wear such a mask virtually all day — never mind the high cost and short supply of N95s, the logistics of fit-testing everyone, the effect on provider morale, etc.

In short, since following this recommendation is currently impossible, one possible response would be to refer all such patients to hospitals.  Bad for everyone.

Let’s hope when the CDC reviews these guidelines, they can provide some more practical (i.e., actually do-able) advice for people in practice.

One Response to “For Suspected H1N1, Get Out the N95 Masks?”

  1. N95 respirator says:

    Swine flu is very dangerous disease. Its almost fatal. Like its is said, “Prevention Is Better Than Cure”, one should cover face with mask to protect from swine flu virus. The N-95 masks are popular. It is basically a surface for entrapment of the virus from outside, so one should wash the mask on a regular basis followed by washing one’s hands and face. For more details on swine flu masks, refer

HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

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NEJM Journal Watch
Infectious Diseases

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