Use masks when there is a risk of droplet or airborne transmission of infection by breathing.
They can also be worn by patients to prevent droplet or airborne transmission.
It may be appropriate for children to wear appropriately fitted masks in some situations. Monitor oxygen saturation if clinically necessary.
The following precautions apply when wearing any type of mask:
- Ensure the mask completely covers the nose and mouth and does not gape.
- Do not touch the mask after putting it on.
- Remove and replace the mask if it becomes wet or soiled.
- Do not wear a mask around your neck.
- Do not reapply a mask after it has been removed.
- Perform standard hand hygiene after touching or disposing of a mask.
Mask types include:
- surgical masks
- standard filtering P2/N95 respirators (also called filtering face-piece respirators, particulate filter respirators, face filters)
- surgical filtering respirators.
The correct type of mask must be chosen according to the situation.
Masks with elastic loops have a use-by date as the elastic perishes with time: masks past their use-by date must be replaced, even if unused.
Separate inner frames (also called support frames or mask brackets), designed to prevent the mask material touching the nose and lips, must not be used with any type of mask.
A surgical mask is intended to prevent the release of potential contaminants from the wearer into their immediate environment. It also protects the wearer’s mouth and nose from large droplets, sprays and splashes of body substances.
Surgical masks can provide some protection to staff and patients where there is a risk of disease transmission by respiratory particles, but (unlike filtering respirators) they are not designed to filter out a high proportion of infectious particles in the surrounding air.
Masks are for single use, for one procedure or episode of patient care, except in extended use (see Extended use of personal protective equipment). A mask is removed and replaced if it becomes wet or soiled, or if the user has touched the front of the mask.
Fitting a surgical mask
Surgical masks have ties/tapes to be tied at the back of the head or elastic ear loops.
To be effective, masks must be fitted correctly. Hands should be cleansed with alcohol-based handrub or liquid soap and water before putting on a mask.
Fit a surgical mask correctly by following these steps:
- Apply the mask by tying the tapes above and below the ears, or placing the elastic loops around the ears.
- Open out the folds of the mask so that the mask covers the mouth and nose comfortably.
- Mould (do not pinch) the area over the bridge of the nose to produce a snug, comfortable fit.
Do not cross the loops at the sides or a gap may form and allow contaminated air in.
If a gap forms because the mask is too large, use a smaller size.
Beards should be avoided because they compromise mask fitting.
Removing and disposing of a surgical mask
Correct handling of used masks is important to prevent the risk of infection of the staff member and patients. When removing a mask with ear loops, remove both loops and pull mask away and down. When removing a mask with tapes or ties, undo or break the tape under the ears first, then lift the top tape over the head.
Dispose of the mask as soon as possible into the appropriate waste stream.
P2/N95 masks (filtering masks; also called filtering face-piece respirators or particulate-filter respirators) are special masks designed to form a very close seal around the nose and mouth, protecting the wearer from exposure to airborne particles including pathogenic biological airborne particulates such as viruses and bacteria.
P2/N95 masks include standard (non-fluid-impermeable) and surgical fluid-impermeable types. Only Therapeutic Goods Administration-registered P2/N95 filtering respirators must be used, to ensure they comply with current relevant standards.2
Use filtering respirators with band straps. (Those with ear loops are not appropriate for health care). They must be fitted correctly to be effective, and wearers must be appropriately trained in their use. Practices should ensure that staff performing high-risk duties are fit-tested and can perform a fit check correctly before each use.
Filtering respirators may be required during respiratory disease outbreaks or when performing aerosol-generating procedures (eg spirometry) and discarded after each patient or procedure.
Once a mask is in place, do not touch the front of the mask, nor pull the mask down intermittently.
See also Extended use of personal protective equipment.
Fit-testing and fit-checking a P2/N95 mask
Employers should ensure that their employees are able to wear a filtering respirator correctly.
A fit test identifies the correct size and style of P2/N95 mask suitable for an individual. Ideally, testing should be performed at the start of employment for staff working in clinical areas where there is a significant risk of respiratory-related droplet and/or airborne transmission. of infectious agents has been identified or could develop.
Fit testing may need to be repeated if the person’s face shape changes or when there is a change in the range of mask types available from the practice’s supplier.
Beards should be avoided because they compromise mask fitting.
Fit checking must be performed every time a P2/N95 mask is put on. Fit checks ensure the mask is sealed over the bridge of the nose and mouth and that there are no gaps between the mask and face. Fit checking must be performed according to the manufacturer’s instructions. Staff members are encouraged to observe each other’s mask fitting and immediately advise of any problem with correct fit.
Note: In office-based practices it may be difficult to ensure that the optimal size and style of mask for each individual staff member, as identified by fit-testing, is always available. Regardless of whether a supply of the ideal mask type for each staff member can be obtained, careful ongoing fit-checking is essential.
Removing and disposing of a P2/N95 mask
Correct handling of used masks is important to prevent the risk of infection to the staff member and patient. When removing the mask, handle only the straps/bands.
The correct removal technique depends on the design. For ‘duckbill’-shaped or cup-shaped respirators, hold both tapes together and lift over the head. For flat-fronted (flat-fold) respirators, lift over the bottom tape, without touching the front of the mask, and let it hang. Then grasp the upper tape and it pull over the head so the whole mask comes away.
Dispose of the mask into the appropriate waste stream.