key: cord-262200-2enorlii
authors: nan
title: Use of masks by health care workers
date: 2020-05-30
journal: Bull Acad Natl Med
DOI: 10.1016/j.banm.2020.05.096
sha: 
doc_id: 262200
cord_uid: 2enorlii

nan

prevent the transmission of SARS-CoV-2. For healthcare workers, the choice of mask may vary depending on whether they are in contact with patients presumed to be healthy, suspect or affected by COVID-19, and according to the type of care [1] .

In all cases, this choice is a compromise: the more effective a mask, the less ''it is permeable'', and the more uncomfortable it is to wear.

In the context of the COVID-19 pandemic, three types of masks are available to healthcare workers: • surgical masks, also known as masks for medical use or anti-projection masks ( the National Academy of Surgery, May 23, 2020.

tecting the wearer. They are not medical devices. Their wearing is more restrictive than that of surgical masks.

FFP2 masks (filtering at least 94% of aerosols) without an exhalation valve are recommended to health professionals performing procedures that expose them to aerosols loaded with fine particles and viruses (the valve provides a better comfort but does not filter); The National Academy of Medicine and the National Academy of Surgery recommend to healthcare personnel:

• in civilian life, to wear a type I surgical mask or a standard ''general public'' mask, industrially manufactured or home-made, as soon as they leave their home. Each person should consider himself as a potential carrier of the virus and contagious, even when he is feeling healthy [3] . As a caregiver he needs to act as an example; • in the professional life, to wear a mask adapted to the risk of contamination:

• a type II surgical mask in community or hospital medicine, during direct contact with patients, especially if they show respiratory signs, a suspected or a confirmed infection, but only if they are not performing an invasive intervention on the respiratory tract, • a type II or type I surgical mask for professionals in charge of first aid, or medical transport, or in contact with a fragile public (EHPAD and home care). These rules must apply even in the non-COVID sector, as any patient is a potential carrier of the coronavirus, • an FFP2 mask without protection valve during acts exposing to fine particle aerosols or viruses (ENT examination, nasal sampling, intubation/extubation, bronchial fibroscopy, dental care, respiratory physiotherapy. . .); • to consult, for correct use of the mask during fitting, wearing and removal, the tutorials [4] and videos [5] available online (Afnor, INRS, ARS, etc.); • to choose an FFP2 mask according to the morphology of the face, a good fitting to the face being an essential condition for effectiveness. The simplest verification test is called ''fit-check'' or ''negative pressure test''. Soft masks (''duck's beak'' and ''pleated'') appear to be more suitable than ''hard shell'' masks. The creation of abacuses from the morphological parameters of the face could help in the choice of a personalized mask; • to use over-gowns, gloves and goggles in addition to the FFP2 mask in certain circumstances, as SARS-CoV-2 contamination may pass through other entry points than the respiratory tract.

The authors declare that they have no competing interest.

Avis du 24 mars 2020 portant sur la place des masques alternatifs en tissus dans le contexte de l'épidémie à COVID-19

Masques et COVID-19

Pandémie de COVID-19 : mesures barrières renforcées pendant le confinement et en phase de sortie de confinement

Bien ajuster son masque pour se protéger

Comment bien oser un masque : la méthode