{"id":502,"date":"2009-09-04T07:30:56","date_gmt":"2009-09-04T12:30:56","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=502"},"modified":"2015-06-04T15:30:17","modified_gmt":"2015-06-04T19:30:17","slug":"for-suspected-h1n1-get-out-the-n95-masks","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/for-suspected-h1n1-get-out-the-n95-masks\/2009\/09\/04\/","title":{"rendered":"For Suspected H1N1, Get Out the N95 Masks?"},"content":{"rendered":"<p><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2009\/09\/the-obama-cope-poster1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-image-503\" title=\"the-obama-cope-poster\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2009\/09\/the-obama-cope-poster-199x3001.jpg\" alt=\"\" width=\"199\" height=\"300\" \/><\/a>So says the Institute of Medicine&#8217;s <a href=\"http:\/\/www.iom.edu\/CMS\/3740\/71769\/72967\/72970.aspx\" target=\"_blank\">recommendations<\/a> for protection of health care workers:<\/p>\n<blockquote><p>Healthcare workers (including those in non-hospital settings) who are in close contact with individuals with nH1N1 influenza or influenza-like illnesses should use fit-tested N95 respirators &#8230; Employers should ensure that the use and fit testing of N95 respirators be conducted in accordance with OSHA regulations.<\/p><\/blockquote>\n<p>Every so often &#8212; well, more like constantly &#8212; my wife (the primary care pediatrician in full-time practice) reminds me what life is like seeing patients outside of a tertiary care, academic medical setting.<\/p>\n<p>Her response to this recommendation to use N95 respirators for evaluation of all &#8220;influenza-like illness&#8221;?<\/p>\n<p>Amazement, incredulity, bafflement, dismay.\u00a0 Seeing as waiting rooms of pediatricians&#8217; offices in the winter are filled with kids with cough, runny nose, and fever, I can certainly understand her response.\u00a0 If these guidelines were followed literally, everyone in these offices would have to wear such a mask virtually all day &#8212; never mind the high cost and short supply of N95s, the logistics of fit-testing everyone, the effect on provider morale, etc.<\/p>\n<p>In short, since following this recommendation is currently impossible, one possible response would be to refer all such patients to hospitals.\u00a0 Bad for everyone.<\/p>\n<p>Let&#8217;s hope <a href=\"http:\/\/www.cdc.gov\/media\/transcripts\/2009\/t090903.htm\" target=\"_blank\">when the CDC reviews these guidelines<\/a>, they can provide some more practical (i.e., actually do-able) advice for people in practice.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>So says the Institute of Medicine&#8217;s recommendations for protection of health care workers: Healthcare workers (including those in non-hospital settings) who are in close contact with individuals with nH1N1 influenza or influenza-like illnesses should use fit-tested N95 respirators &#8230; Employers should ensure that the use and fit testing of N95 respirators be conducted in accordance [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,8,9],"tags":[167,398,461,500,589,636,637,753,787,803,823],"class_list":["post-502","post","type-post","status-publish","format-standard","hentry","category-infectious-diseases","category-patient-care","category-policy","tag-cdc","tag-h1n1","tag-hospital","tag-influenza","tag-mask","tag-n-95","tag-n95","tag-primary-care","tag-recommendation","tag-respiratory","tag-safety"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/502","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=502"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/502\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=502"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=502"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=502"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}