Who is protecting us? CDC N95 mask for H1N1

lamazeteacher · Oct 29, 2009

The answer to that, is no one but we, ourselves can protect us. If your hospital doesn't provide needed, recommended N95 masks, buy your own for your use, and bill your employer for them. When enough of you do that, contact your media for exposure of it. Believe me, you'll get the N95s. Please, just be sure they're fitted properly so that no air escapes when you wear it and blow forcefully. As most of us have found, when we buy our own equipment (stethascopes) we get one we can trust. N95s are cheaper.

The government has been preoccupied with the economic situation, Afghanistan and Health insurance companies' self indulgernce and diplomatic Health Care Reform without reaching acceptable conclusions for any of those situations. CDC protects its own interests, even eschewing Canadian studies on 2,000 people that showed that H1N1 vaccine needs to be given BEFORE seasonal flu vaccine, due to increased susceptibility of those who had seasonal vaccine first, to get H1N1 flu quickly thereafter (like I did). Without any evidence of having done any American studies, they have told epidemiologists throughout our country, that the Canadian study couldn't be replicated! True. No funding here for that study, or time or personnel was allotted to do it! Such puffery is intolerable and too costly in morbidity and loss of human lives! That doesn't sound like a mild flu to me.

The public has been nattering on about their suspicions that our Health agencies administer "dangerous" vaccines that have tiny bits of mercury in its composition (there for the purpose of distributing it more evenly, incidently), while thimerasol free vaccines can be obtained for most of them. However in Los Angeles, it was demonstrated that most people want it, by the lengthy lines of people waiting (mostly in vane) to be vaccinated. There, they didn't even vaccinate those at highest risk first. In Northern CA, they did place signs indicating that high risk individuals would be vaccinated first, and ran out of vaccine in the middle of the second day they had it.

Like Nero fiddling while Rome burned, our elected statespeople have been twittering and quibbling about the above topics, while the FDA refused to approve Glaxo Smith's vaccine that was ready for pick-up weeks ago. Canada picked up their contracted amount of vaccine from them, and set their priorities regarding how and to whom it would be administered, and did that for high risk persons first, and before the administration of seasonal flu vaccine, to avoid untimely deaths from subsequent increased susceptibility to H1N1. There will need to be considerable "Monday night quarterback" consideration of statistics following this debacle, when they show fewer mortality and morbidity in Canada and other countries, from H1N1. Just as comparisons of the loss of fetal and newborn lives in the USA is higher than is tolerable, and that has received the "Oh, well" kind of notice.

Do I sound furious? Well, I am! I have lived in the USA for 47 years, wondering and watching for some relief from medical costs that are obscenely visible; and thinking that all the proposals for relief of that would reach fruition. However as I watch the considerable efforts of well meaning, bright people and their not-so-bright and/or downright unscrupulous opponents, I watched my Canadian family members, one of whom is a physician there, who are in wonder that Americans put up with the deficiencies in health care, and I wonder what keeps me here. The answer is always, my children and their children.

I work hard for the changes that seem ever close, until they're shot down in one or both governmental houses. Supporting Obama in VA wasn't easy, as I sought to reveal the blatant lies that accompany each improvement planned for health care. Finally the truth becomes evident, once noses are shoved into the garbage claims we've had to disprove.

It reminds me of a child's story from long ago, in which the protagonist says in a tiny voice, "I looked all around for the enemy, and saw that the enemy was me". To be protected, we must do it ourselves. If we fall for whatever we hear that smacks of the old victim, rescuer, perpetrator triangle described by Eric Berne in his book "Games People Play", we see that all three is me. Drama occurs when the roles rotate, and we see others in those roles. Some people prefer drama to calm determination.

Hoozdo, ADN · Oct 30, 2009

I have go to wonder how expendable are we ? We have the ruling n95 mask need to be worn we taking care of the h1n1 patient. My hospital amoung many are useing floor mask to surgical . Whos overseeing they are following cdc and protecting us and american public. Today i see big problem when were trying to stop the panademic phase but are not taking precautions and ignoring cdc regulation and recommendations. Whos checking into this? Pt are comming to floor without testing or if they are they testing is not accurate. So why are they not automatic isolation ?

Sorry to say that the CDC has changed their position on using N95 masks for H1N1.

We discussed this in this link:

https://allnurses.com/general-nursing-discussion/my-hospitals-new-432605.html

allnurses Guide · Oct 30, 2009

sorry to say that the cdc has changed their position on using n95 masks for h1n1.
we discussed this in this link:
https://allnurses.com/general-nursing-discussion/my-hospitals-new-432605.html

cdc october 14, 2009

http://www.cdc.gov/h1n1flu/guidance/ill-hcp.htm

...the following isolation precautions are recommended for healthcare personnel who are in close contact with patients with suspected or confirmed 2009 h1n1 influenza. for the purposes of this document, close contact is defined as working within 6 feet of the patient or entering into a small enclosed airspace shared with the patient (e.g., average patient room)...

respiratory protection - recommendation: cdc continues to recommend the use of respiratory protection that is at least as protective as a fit-tested disposable n95 respirator for healthcare personnel who are in close contact with patients with suspected or confirmed 2009 h1n1 influenza.

this recommendation applies uniquely to the special circumstances of the current 2009 h1n1 pandemic during the fall and winter of 2009-2010 and cdc will continue to revisit its guidance as new information becomes available, within this season if necessary

basis: the current recommendation is based on the unique conditions associated with the current pandemic, including low levels of population immunity to 2009 h1n1 influenza, availability of vaccination programs well after the start of the pandemic, susceptibility to infection of those in the age range of healthcare personnel, increased risk for complications of influenza in some healthcare personnel (e.g., pregnant women), and the potential for healthcare personnel to be exposed to 2009 h1n1 influenza patients because of their occupation....

http://www.cdc.gov/h1n1flu/guidance/ill-hcp.htm

Pfiesty · Nov 3, 2009

JobSearching RN: OSHA is respecting CDC's guidelines and will find violations in facilities not following those guidelines.

Hoozdo: I just checked now and the CDC remains consistent on their recommendation on N95 masks. I was told also by management that they changed theitr recommendations also. But when I asked for the documentation, they provided copies of letters from cost-containment-concerned entities to the CDC asking the CDC to consider their standards. I check frequently and CDC has not waivered yet on this issue, so check the sources.

indigo girl · Nov 3, 2009

We should all be aware that SHEA has been pushing for a return to the use of the surgical mask. Looks like they may well win this round. Of course, they are not the ones at the bedside providing patient care, now are they?

Here is their position statement:

http://www.shea-online.org/Assets/files/policy/061209_H1N1_on_Letterhead.pdf

As noted earlier, we recommend the use of surgical masks for respiratory protection during routine patient care activities as opposed to continued universal use of N95 particulate respirators. Inappropriate and widespread use of N95 respirators for all novel H1N1 patient care activities does not provide increased protection against the virus and may have an adverse impact on patient and healthcare worker safety. Namely, reports of limited supplies of N-95 respirators during the current novel H1N1 outbreak raise concerns of respirator availability in healthcare settings at times when they are actually needed. Since respirators are essential components of infection prevention and control strategies for truly obligate airborne pathogens such as M. tuberculosis, a shortage of respirators could put healthcare workers at increased risk in the event proper respiratory protection is unavailable for the care of patients infected with airborne- transmissible pathogens.
Transmission of influenza in acute care hospitals is a risk many magnitudes lower than the risk of community transmission and strategies that place excessive focus on preventing influenza transmission within healthcare facilities are of limited utility in an outbreak and divert attention from important community control strategies.

Yesterday reserchers from Australia dropped a bombshell of a retraction to their reseach on the efficacy of the N95 vs the surgical mask. Now, this reseach does not speak directly to exactly how influenza is transmitted but it may well cause the CDC to

change guidelines yet again. To be frank, there is a lot of pressure due to the cost

and supposed shortages of the N95. The IOM recommended the use of the N95 to

the CDC based on the available research. Dr. Raina McIntyre's research made a big impact at the IOM hearings, and now her team is retracting their results. It was

not the only data presented however, but this has not been helpful.

I can well imagine the pressure on the CDC to change those guidelines. We, of

course, have no voice in that decision. Nurses spoke at the IOM meeting, but

ultimately, CDC makes issues the guidelines. Of course, many facilities are already

not following the current guidelines and giving staff the N95 as many of you have

been reporting in these threads.

http://abcnews.go.com/Health/SwineFluNews/flu-mask-decision-based-flawed-study-authors/story?id=8966585

After a re-analysis prompted by questions from reviewers, the findings were no longer significant, said Holly Seale of the University of New South Wales in Sydney, Australia.
The original study, presented earlier this year, formed the basis of some recommendations on the use of masks in a health care setting.
The retraction -- near the end of a presentation at the annual meeting of the Infectious Diseases Society of America -- prompted a "rush to the microphones" by those involved in flu prevention, one expert said.

Pfiesty · Nov 3, 2009

I just copied this from SHEA's website. (Disclosure: Underlining is mine, not theirs.)

"SHEA is ........ influential in guiding decision-making bodies towards rational, effective, cost-conscious policies."

Consider the source.

indigo girl · Nov 3, 2009

I just copied this from SHEA's website. (Disclosure: Underlining is mine, not theirs.)
"SHEA is ........ influential in guiding decision-making bodies towards rational, effective, cost-conscious policies."
Consider the source.

Yes, and they admit to being influential. How they must hate that the last guidelines went against their "expertise".

I heard them arguing about this at the CIDRAP conference. This debate was jokingly called "the Holy War on PPE" by a doc that worked for the 3M company speaking at that conference in Minneapolis.

Hoozdo, ADN · Nov 4, 2009

I have been getting many H1N1 pts in my assignments. The day I don't have N95 masks to use is the day I am going to refuse my assignment.

The facility policy is now face masks for routine care and N95s for bronchs, etc. Luckily, they have not been stingy with the N95s for everyday care.

JobsearchingRN · Nov 4, 2009

Well here a update on our mask. If we are wearing H1N1 mask you have to keep it for entire 12 hour shift in a baggy and keep reusing it. I sent a notice to infection control they have yet to comment cdc recommend h1n1 only . They other mask are not ok with up close personel care. I have yet to hear back from them. A few N95 have been seen around hospital recently. We are not using reverse isolation rooms and we have 6 . Go figure. Hope you are all keeping yourself safe. It not a option to refuse a job given anymore . Appear we loose our job if we do. If they keep going you wont have right to ethical question or question a medication . Im just little scared they have deteriated our respect for our job to far. My patient feel Im awesome and they relizes nurses are backbone of doctors. Why cant they get the hint.

JobsearchingRN · Nov 4, 2009

I got to really wonder where is the media with this one? Healthcare worker and patient are expendible and not given proper PPE . Anybody know if nurses assosciation is trying to publize this. I have seen more shot outside hospital given than in. Policy is not N95 but surgical mask. Furthermore, to top it off if you get H1N1 and your tested and dont fit N95 you still get the patient. Respiratory however are to wear the N95. I got to say nurses are going to have to make a stand to make it better. I am so dissappointed to be in such a field that has so little respect for nurses lives,patients and visitors and to allow this virus to spread with improper PPE. We are to be a caring and proactive for health and care of humanity. If we are not the leader than what is going on beyond our institutions. I guess im a old type nurse. People lives at risk it shouldnt be compromised ! There are more punishment in place to kick the nurse to curb and blame her than to save a life. Its sad!

Pfiesty · Nov 4, 2009

job searching rn:

you are so correct!

this from http://www.cdc.gov/h1n1flu/guidelines_infection_control_qa.htm :