TY - JOUR
T1 - Adapted full-face snorkel masks as an alternative for COVID-19 personal protection during aerosol generating procedures in South Africa
T2 - A multi-centre, non-blinded in-situ simulation study
AU - Herselman, Ronel
AU - Lalloo, Vidya
AU - Ueckermann, Veronica
AU - van Tonder, Daniel J.
AU - de Jager, Edwin
AU - Spijkerman, Sandra
AU - van der Merwe, Wanda
AU - du Pisane, Marizane
AU - Hattingh, Fanie
AU - Stanton, David
AU - Hofmeyr, Ross
N1 - Funding Information:
The authors wish to thank the Faculty of Health Science, University of Pretoria who provided financial assistance through the Leeds University COVID-19 funds for this study. Thanks also go to both Faculties of Health Sciences at the Universities of Pretoria and Cape Town for providing their skills laboratories and equipment for data collection; the participants from Steve Biko Academic and Groote Schuur Hospitals who offered their support and time, and Aqua Divers International (Pty) Ltd. for supplying the masks and other material tested in this study.
Funding Information:
The authors wish to thank the Faculty of Health Science, University of Pretoria who provided financial assistance through the Leeds University COVID-19 funds for this study. Thanks also go to both Faculties of Health Sciences at the Universities of Pretoria and Cape Town for providing their skills laboratories and equipment for data collection; the participants from Steve Biko Academic and Groote Schuur Hospitals who offered their support and time, and Aqua Divers International (Pty) Ltd. for supplying the masks and other material tested in this study.
Publisher Copyright:
© 2021
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
KW - COVID-19
KW - Full-face snorkel mask
KW - N95 alternatives
KW - Personal protective equipment (PPE)
KW - SARS-CoV-2
UR - https://www.scopus.com/pages/publications/85117949579
U2 - 10.1016/j.afjem.2021.08.002
DO - 10.1016/j.afjem.2021.08.002
M3 - Article
AN - SCOPUS:85117949579
SN - 2211-419X
VL - 11
SP - 436
EP - 441
JO - African Journal of Emergency Medicine
JF - African Journal of Emergency Medicine
IS - 4
ER -
