Emergency Mask Option:

• If a hospital has access to N95 masks and feels they will be available over the next few months, re-using N95 masks is currently the most prudent plan. Sterilization methods of these masks are summarized below.
• In lieu of reusing N95 masks, it is imperative that hospitals screen and approve the type of homemade products that they are allowing their staff to use. The CDC mask instructions have flooded the market with simple ‘cotton’ masks without any filter and thus workers think they are ‘safe’ by using a ‘CDC approved mask’. The message needs to get out that they should only be using masks that have a suitable filter inside them.
• We must find a fast solution and get our patient-facing workers protected with some sort of face mask right away, even if those options are less than ideal.
• It is also imperative to understand that everything we offer as ‘hospital approved’ homemade alternatives, extended uses of commercial masks, etc… will not be ideal but also the only real options we may have at this point. It is essential that healthcare employees understand that it is not just a matter of ‘trying harder’ to order more masks but instead we must accept less than ideal options for most likely many months (possibly the rest of 2020).
• In the short term, the purchasing departments should be ordering ‘meltblown non-woven polypropylene’ rolls right NOW. These materials will not arrive for 1-2 months in all likelihood but we will need them even more in a few months so order all you can NOW.
• If your hospital has a supply of AAMI-3 gowns and CSR Wraps, please follow the Homemade mask details so all seamstresses make the same outer housing to match the shape of the filters cut out of the gowns and wraps

Recommended Filter:

• Currently the best emergency filter sources that face mask and non-woven industry experts can recommend as raw materials that we have ‘on hand’ is AMI 3 surgical gowns and CSR Wraps. These products are made of the SMS layered materials that we want but are not exactly the same as commercial mask materials. All inventory of AAMI 3 gowns and CSR Wraps should be repurposed and cut into filters to get through the next few months of shortage. Because these materials are not as porous as commercial face masks they will not breathe as easily and thus are not ideal but the best materials experts can recommend which are available right away.
• These filters should be carefully cut from the AAMI-3 gowns and CSR wraps to conserve the material you have on hand.
• Once these are cut (in-house with a Cricut, or by a select homeowner), they can be parceled out to authorized seamstresses from your local community
• The filters should be cut to fit carefully inside the homemade masks so it is critical that all seamstresses helping you make the outer masks are using the same pattern for the filters to fit
• It is also important the outer mask have an opening in the side to remove the filters to the outer masks can be washed and the filter can be sterilized with an oven or an autoclave (see details for this)

Recommended Outer Mask Design:

• Because the AAMI3 and CSR wraps are not as porous it is important that we include outer face mask designs which seal tightly to the face to minimize air flow AROUND these filters and out the sides of the masks. The best fitting homemade face mask design is a domed shape which simulates the N95 as opposed to the rectangular homemade versions of a surgical mask design. However, the dome design may take a few more minutes to cut out for seamstresses compared to rectangular designs. Therefore we encourage the public to use Cricuts and similar cutting machines to pre-cut out the fabrics to make an outer mask to extend the life of our AAMI 3 filters. These masks are comfortable and when made with 2 ties (not 2 ear loops) they fit very snug to the face with a good seal. These fabric masks should have a slit to replace the filter and remove it when washing the mask itself.

Use and Care of Homemade Fabric Masks: details for the use of care of the filter and fabric mask is detailed below.

• Filter Replacement: It is critical that the filter not be washed and exposed to any chemical such as soaps or chemical sanitizers. Each filter should be issued to individual workers and they should be trained to record (directly on the filter material itself) the number of hours of use, number of sterilizations, etc…. The number of hours and the number of sterilizations that each filter can withstand will depend greatly on the available AAMI 3/CSR wrap materials each hospital has available and how long those supplies are projected to last.