[MCOH-EH] MCOH-EH Digest, Vol 251, Issue 27

[Diane Shaw]

Mary,
PAPRs cannot be used in the OR, as they are an Infection Prevention issue. I am also a member of the Association for Professionals in Infection Control and Epidemiology (APIC) and this question has appeared on that list serve many times. Here are some of the responses to support the decision:

1:
This email is in response to your inquiry to the Centers for Disease Control and Prevention (CDC). Your question was forwarded to the National Personal Protective Technology Laboratory (NPPTL) for reply.   

PAPR use in the Operating Room (OR) has not been recommended as there is a lack of evidence to support any impact (contamination of wearer's expired unfiltered air) on the sterile field. AORN's recommended practice, due to the lack of evidence, is to use a fit tested N95 respirator with airborne precautions. 
In the context of OSHA 1910.134(d)(1)(iv) (https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=standards&p_id=12716) : The employer shall select respirators from a sufficient number of respirator models and sizes so that the respirator is acceptable to, and correctly fits, the user.  
AORN's journal article Proper Use of Surgical N95 Respirators and Surgical Masks in the OR is another source to review. (http://www.aornjournal.org/article/S0001-2092(13)00103-8/abstract) 

Thank you again for contacting us with your inquiry. 
I hope this information is helpful. 

Thank you, 

Marisa Fries 
Health Communication Intern
National Personal Protective Technology Laboratory (NPPTL)
National Institute for Occupational Safety and Health (NIOSH)

2:
CDC guidelines simply say that no respirator with exhaust may be used in an area with a sterile field/OR.  Even if the airflow comes out of the gown, it is blowing onto the floor, so will create movement of any particles/organisms on the floor.   Consulted from OR OSHA and the state do not result in a response indicating that it is ok to use PAPRs.  
3:
I recently have investigated this issue at OHSU. I reviewed several documents and also contacted the manufacturer of the PAPRS we currently use. I contacted NIOSH and CDC. It turned out that PAPRs are not recommended to be used in the OR/sterile field. Now, we recommend our OR staff to use N95. However, there are some employees (like men with beard) who fail to get fit tested N95, and that is bit challenging. It also depends on the model of the PAPRs.

We do not allow them in our ORs. I hope this helps!

Diane M. Shaw, RN, BSN, CIC, COHN-S
Tuality Healthcare
Employee Health Services
335 S.E. 8th Ave
Hillsboro, OR 97123
Phone: 503.681.1444
Fax: 503.681.4170
Tues.-Fri. 0730-1700 hours


The contents of this transmission may be confidential in nature and should be directed only to the addressee. Do not read, copy, or disseminate this material unless you are the intended recipient. If this transmission has reached you in error, please forward this e-mail to the sender to advise, then destroy the message. 


-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of mcoh-eh-request at mylist.net
Sent: Wednesday, April 20, 2016 12:00 PM
To: mcoh-eh at mylist.net
Subject: MCOH-EH Digest, Vol 251, Issue 27

Send MCOH-EH mailing list submissions to
	mcoh-eh at mylist.net

To subscribe or unsubscribe via the World Wide Web, visit
	http://mylist.net/listinfo/mcoh-eh
or, via email, send a message with subject or body 'help' to
	mcoh-eh-request at mylist.net

You can reach the person managing the list at
	mcoh-eh-owner at mylist.net

When replying, please edit your Subject line so it is more specific than "Re: Contents of MCOH-EH digest..."


Today's Topics:

   1.  PAPR use in the OR suite (Spangler, Mary)


----------------------------------------------------------------------

Message: 1
Date: Wed, 20 Apr 2016 18:57:14 +0000
From: "Spangler, Mary" <MSpangler at stanfordhealthcare.org>
To: "mcoh-eh at mylist.net" <mcoh-eh at mylist.net>
Subject: [MCOH-EH] PAPR use in the OR suite
Message-ID:
	<6B1542C0199903499FE8CBDB8380D5BA58638B5C at SHEXPSCMX112.Enterprise.stanfordmed.org>
	
Content-Type: text/plain; charset="us-ascii"

Do any of your institutions allow for the use of a PAPR during surgery if it is the full PAPR hood? Do any of you have a P&P around this?  Any particular brand?

Thank you so much,

Mary

Mary Spangler, M.S., N.P., COHN-S
Administrative Director, Occupational Health Services Stanford Health Care & Stanford Children's Health Care
300 Pasteur Drive, M/C 5205, Stanford, CA 94305-5513
Office: (650) 725-9583 Fax: (650) 498-7748 (fax) mspangler at stanfordhealthcare.org<mailto:mspangler at stanfordhealthcare.org>
[Description: logo sig.png]                        [Description: Stanford Children Health]
Confidential Information: This communication and any attachments may contain confidential or privileged information for the use by the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or the attachments is strictly prohibited. If you have received this communication in error, please contact me and destroy all copies of the communication and attachments. Thank you.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://mylist.net/archives/mcoh-eh/attachments/20160420/4228b717/attachment-0001.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image001.png
Type: image/png
Size: 14497 bytes
Desc: image001.png
URL: <http://mylist.net/archives/mcoh-eh/attachments/20160420/4228b717/attachment-0001.png>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image002.jpg
Type: image/jpeg
Size: 4289 bytes
Desc: image002.jpg
URL: <http://mylist.net/archives/mcoh-eh/attachments/20160420/4228b717/attachment-0001.jpg>

------------------------------

Subject: Digest Footer

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): http://mylist.net/archives/mcoh-eh/
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------
When replying to a message, PLEASE delete all footers, and all messages to which you're NOT replying, so the topic of your reply is immediately clear to other list members.

------------------------------

End of MCOH-EH Digest, Vol 251, Issue 27
****************************************