Adapted full-face snorkel masks as an alternative for COVID-19 personal protection during aerosol generating procedures in South Africa: A multi-centre, non-blinded in-situ simulation study

Ronel Herselman, Vidya Lalloo, Veronica Ueckermann, Daniel J. van Tonder, Edwin de Jager, Sandra Spijkerman, Wanda van der Merwe, Marizane du Pisane, Fanie Hattingh, David Stanton, Ross Hofmeyr

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Introduction: SARS-CoV-2 has resulted in increased worldwide demand for personal protective equipment (PPE). With pressure from ongoing epidemic and endemic episodes, we assessed an adapted snorkel mask that provides full-face protection for healthcare workers (HCWs), particularly during aerosol-generating procedures. These masks have a custom-made adaptor which allows the fitment of standard medical respiratory filters. The aim of this study was to evaluate the fit, seal and clinical usability of these masks. Methods: This multicentre, non-blinded in-situ simulation study recruited fifty-two HCWs to don and doff the adapted snorkel mask. Negative pressure seal checks and a qualitative fit test were performed. The HCWs completed intubation and extubation of a manikin in a university skills training laboratory, followed by a web-based questionnaire on the clinical usability of the masks. Results: Whilst fit and usability data were generally satisfactory, two of the 52 participants (3.8%) felt that the mask did not span the correct distance from the nose to the chin, and 3 of 34 participants (8.8%) who underwent qualitative testing with a Bitrex test failed. The majority of users reported no fogging, humidity or irritation. It was reportedly easy to speak while wearing the mask, although some participants perceived that they were not always understood. Twenty-one participants (40%) experienced a subjective physiological effect from wearing the mask; most commonly a sensation of shortness of breath. Discussion: A fit-tested modified full-face snorkel mask may offer benefit as a substitute for N95 respirators and face shields. It is, however, important to properly select the correct mask based on size, fit testing, quality of the three-dimensional (3D) printed parts and respiratory filter to be used. Additionally, HCWs should be trained in the use of the mask, and each mask should be used by a single HCW and not shared.

Original languageBritish English
Pages (from-to)436-441
Number of pages6
JournalAfrican Journal of Emergency Medicine
Volume11
Issue number4
DOIs
StatePublished - Dec 2021

Keywords

  • COVID-19
  • Full-face snorkel mask
  • N95 alternatives
  • Personal protective equipment (PPE)
  • SARS-CoV-2

Fingerprint

Dive into the research topics of 'Adapted full-face snorkel masks as an alternative for COVID-19 personal protection during aerosol generating procedures in South Africa: A multi-centre, non-blinded in-situ simulation study'. Together they form a unique fingerprint.

Cite this