This is a MUST READ on the why, the how, and the what of the current COVID mask crisis with front line information from the perspective of an ER nurse practitioner and what  YOU CAN DO TO HELP! 

The Real Mask Breakdown and How You Can Help ~ From the Perspective of an ER Nurse Practitioner

 

Hi friends!  I hope you are all staying well!  This is a strange departure from my normal post, and what many may not realize is that I am also a dual-certified nurse practitioner in the emergency department with specialties in adult/geriatric critical care and family medicine.  

Today my goal is to bring you useful front line information where we will talk about the why, the how, and the what of the current mask crisis and then convert that information into practical ways in which YOU can help today. As one of my colleagues so aptly said, “We don’t need pity, we need PPE.”  Friends, let’s make it happen.  

This is the real mask breakdown. 

The Real Mask Breakdown and How You Can Help ~ From the Perspective of an ER Nurse Practitioner

Why masks?

First of all, when I started my DIY blog a year ago never in a million years did I imagine these two worlds colliding in a post about the most effective way to DIY personal protective equipment for my colleagues in medicine around the world, but desperate times call for desperate measures.

So let’s start with the why.  Why masks?  There are 3 points of entry for viral pathogens into our bodies – our eyes, our nose and our mouth.  Masks are one of two ways in which we protect ourselves from these pathogens as they cover our nose and mouth.  The other form of personal protective equipment (PPE) is eye wear or safety glasses.

There are 2 types of masks we use with regularity in medicine.

1.  Surgical mask
2.  N95 mask

The surgical mask is the simplest form of protection and worn commonly in day to day practice.  It is a thinner material and fits more loosely around the face.  With the current COVID climate, we are wearing these masks from the moment we start our shift until we clock out.  This is the mask that DIYers are trying to replicate at home whether it be for themselves or local hospitals.

The N95 is a medical mask that is more effective at filtering particulates that are airborne such as much smaller, sneakier viral pathogens.  This mask fits very closely to the face and is a thicker material similar to a vacuum bag.  These masks are typically worn with patients who are COVID positive or suspected to be positive as it provides much better protection than the simple surgical mask.

The Real Mask Breakdown and How You Can Help ~ From the Perspective of an ER Nurse Practitioner

How did we run out of masks?

How in the world, or more to the point, how in the United States of America, is it possible that nurses are having to resort to using bandanas to protect themselves as opposed to a mask?  Frankly, this is a fair question to ask.  I offer no fancy political opinion, but merely the humble observation of someone who has worked in emergency medicine for over a decade.

It is a simple (or not so simple) matter of supply and demand.  Up until a month ago I could not have even told you where we stocked our masks.  When you are coughed on, puked on, bled on, peed on, and even pooped on by strangers on a daily basis, wearing a mask feels like opening an umbrella after you’ve already run through the rain.     In nursing school I was taught, “I can do all things through Christ who strengthens me . . . with gloves.”  (Philippians 4:13 – the Cedarville University Nursing School Version).  Hallelujah and amen.  But a mask?  Well, more often than not for those of us in the ER it feels like an exercise of futility.

I cannot speak for everyone, but I would be willing to suggest that my ER colleagues have spent more time in a mask over this last month then they have in their entire careers.   I know I sure have.   Not only are medical staff wearing masks like we never have before, but we are also putting patients, their mother and their great-aunt’s neighbor in a mask as well.  If you come in because your ankle hurts, you get a mask.  If you come in with abdominal pain that has been ongoing for 30 years for which you have seen every specialist known to mankind, and you decide today is the day the ER is going to figure it out guess what?  You get a mask.  You can see how quickly and unexpectedly the demand skyrockets above the supply.

Regardless, no colleague of mine in medicine deserves to work in a bandana over their face.  Or a maxi pad stuck to their lips.  Or a sponge tied to their head.

The Real Mask Breakdown and How You Can Help ~ From the Perspective of an ER Nurse Practitioner

What can you do to help?

You say, I would love to help make masks, but I can’t sew.  Join the club.  Unless I am stitching a human being back together I am helpless.  But there are other ways to help! Do you know someone who can rock a sewing machine and is willing to help?  Consider donating the materials.  Arrange a digital “sewing circle” through Zoom and set aside a certain amount of time each day that you will “meet” and sew together.  Even if you can’t sew, hop on and enjoy socializing!  Below is a great tutorial on the most effective DIY mask for our hospital providers that are desperate enough to be wearing bandanas.

The Best Material for a DIY Mask

Before you watch the how to video, though, you must know the best materials!  Researchers at Cambridge University tested a wide range of household materials for homemade masks. Remember we are trying to recreate that simple surgical mask.  To measure effectiveness, they shot Bacillus atrophaeus bacteria (0.93-1.25 microns) and Bacteriophage MS virus (0.023 microns in size) at different household materials.

They measured what percentage the materials could capture and compared them to the more common surgical mask.

Courtesy of Smart Air

On average, the homemade masks captured 7% fewer virus particles than the larger bacteria particles. However, all of the homemade materials managed to capture 50% of virus particles or more (with the exception of the scarf at 49%).

 

Researchers’ Pick for Best-Performing Homemade Mask Material

Based on particle capture and breathability, the researchers concluded that cotton t-shirts and pillow cases are the best choices for DIY masks.

Courtesy of Smart Air

Use pillowcases and 100% cotton t-shirts for DIY masks!

The video below is an excellent tutorial on how to make a face mask with the filter pocket.

The key in this tutorial is the filter pocket.  Medical providers who are truly without mask options can cut up surgical gowns and fold this material into the pocket.  Even if your local hospital isn’t accepting DIY masks at this time, store them in a box and keep an eye on the local news because needs change quickly and desperate times call for desperate measures.  In the end, your masks could make all the difference.  

 

The Real Mask Breakdown and How You Can Help ~ From the Perspective of an ER Nurse Practitioner

Let’s Not Forget Eye Protection

Across America (and the world!) medical professionals are  most commonly wearing disposable, flimsy plastic eye protection.  I spent one shift in the exact mask below and said forget it, there has to be a better option.   The plastic arms were breaking down the skin over my ears, and the shield fogged up every time I breathed.

I bought myself a pair of durable, comfortable protective eye wear that didn’t fog up and was so much happier that I bought them for our whole emergency department.

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Some of our ER staff rocking the new eyewear.  Don’t we look so smart?

Consider donating a box of any of the below protective eye wear to your local emergency department for more durable, comfortable eye protection.  When having to wear these all shift, I promise such a donation will be greatly appreciated!  If these are sold out, then search for durable eye protection that mentions being fog and scratch resistant.  We are no help if we can’t see our patients!  Also to note, there shouldn’t be any issues for the hospital accepting these as they are no different than wearing eye glasses.  Masks you need to check with your local hospital first.

#1.  MAGID Y50BKAFC Iconic Y50 Design Series Safety Glasses with Side Shields | ANSI Z87+ Performance, Scratch & Fog Resistant, Comfortable & Stylish, Cloth Case Included

 

#2.  Magid Glove & Safety ANSI z87 Anti-Fog Safety Glasses (12 Pair), Anti-Fog Coating

#3.  MAGID Y17CFPAFC ANSI z87 Safety Glasses

#4. SAFE HANDLER Clear Lens Color Temple Safety Glasses 

#5. JORESTECH Eyewear Protective Safety Glasses, Polycarbonate Impact Resistant Lens 

As someone once said, “Kindness is a gift everyone can afford to give.”

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It is essential that we are armed with useful front line information in order to effectively fight this battle.  Click on the social media icons at the bottom of the post to share!

Someone also once said, “Laughter is the best medicine.”  So I am prescribing you a large dose of it.  These DIY experts put my creativity to shame.

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Stay well.  Be kind.  Choose Joy.

“Rejoice in the Lord always. I will say it again: Rejoice! Let your gentleness be evident to all. The Lord is near. Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.”

Philippians 4:4-7