We expected to be overwhelmed by COVID-19 cases,” says Dr. Colleen Foster, an emergency medicine physician in Colorado. “There was an early surge here, so we started planning for more ventilators and more protective equipment,” she says. “It’s actually been more of a slow burn than a big spike, but there is sustained activity at our hospital.”
In those early days, before most of the country began their stay-at-home orders, Colleen – like many healthcare leaders – started digging in to learn more about how to help protect her team. She recalls having a visit from her sister, Kris, an engineer at 3M, and asking her a lot of questions about particulate respirators. “I was active during the Ebola outbreak, so I was familiar with using N95 respirators,” Colleen says. “During that time we learned donning and doffing techniques. We were told to use one respirator per patient. That isn’t the case for COVID-19,” she said. That discussion left her thinking about other options in the market that may be worth exploring to keep her and her team protected.
Working through respirator options
Colleen says that, like many healthcare facilities, her facility didn’t have adequate supplies of personal protective equipment (PPE) at the beginning of the outbreak when they were seeing a small surge. “We were measuring our PPE by the number of days until we would run out,” she says. “There were times when we projected having less than one week left of supplies.”
Her facility was following U.S. Centers for Disease Control and Prevention (CDC) guidelines for extended use of N95 respirators in emergency situations, which included limiting use to aerosol-generating procedures, like intubations or high-flow oxygen administration – both of which are common treatments for COVID-19. When they started running low on PPE, Colleen started to investigate other options for respiratory protection.
She investigated another available option – powered air-purifying respirators (PAPRs) — but that equipment created communication challenges that weren’t ideal for her emergency department, as decisions and care paths are determined in-the-moment as a team. “While the PAPRs were great for comfort, they didn’t provide us the flexibility for critical communications that needs to take place, often rapidly, in our ER,” she says.
Reusable respirators and budget challenges
Those options seemed less than ideal to Colleen given the type of work her team needed to do, so she continued looking. She adds that comfort is important, but clinicians are more comfortable when they have confidence in their PPE. “It’s relative,” she says. “It is more comfortable to wear a respirator than to be anxious. Health care providers need to be focused on our patients. I have two young children and a husband at home, so I’m making decisions about risk for myself and my family.” Looking for other respiratory protection options, she ordered two different reusable respirators – one full facepiece respirator and one half facepiece respirator.
After getting approval to try them out at work, she realized the full facepiece respirator was also not working well for her communication, but the half facepiece respirator was a viable solution. However, due to budget constraints, the number of reusable respirators she was going to be able to source wouldn’t cover the entire team of doctors, nurses and techs. “We’re all at risk – we’re all getting close to people to do our jobs,” Colleen says. “Not protecting my entire team wasn’t an option.” So, she started a crowd-sourced fundraiser and raised $53,000 in four days – enough for the medical team to get reusable respirators.
“This was such a big morale booster for our team,” she say. “I think that advocacy was what people needed.” She talked to a PPE specialist at 3M and he suggested the 6000 series of respirators for comfort and features. “It has a speaking diaphragm, which is important,” she adds.
“If this is a new normal for a while,” Colleen says, “I want to find ways for healthcare providers to have respiratory protection that can be worn for a long time. We want something that is reusable and that can be relatively comfortable. And the fact that you can clean and decontaminate it is very important.”
Learn more about Reusable Respirators here and see if they are an option for your facility.