We are having intermittent problems obtaining PPE especially masks at our clinic. We are independent. Does anyone have suggestions on substitutions for masks during the essential parts of both the hemodialysis and peritoneal dialysis.
These are strange and uncertain times, aren’t they? I am not a clinician, but have tried to keep tabs on what clinics are doing and on the recommendations. Unfortunately, a seemingly large number of in-center HD clinics are making patients wear masks for the entire treatment. This can certainly protect staff from patients who cough or sneeze, but is of questionable value for asymptomatic patients, doesn’t protect the patients, (in fact, it is make some anxious enough to consider stopping dialysis altogether), and wastes a scare resource. IMHO, it would be best to restrict this policy to patients who ARE symptomatic, and then make sure the masks are worn correctly (i.e., not under the nose).
For PD at home, a mask is needed. Since so many are being used up in-center, PD patients are being told to reuse their mask for a week at a time. With the goal of not allowing air flow–particularly breath–on a PD catheter while it is open, a homemade washable fabric mask or bandana (with a coffee filter inserted if possible) might be a better short-term option than reusing a paper mask.
For home HD, a mask would really only be needed for patients who have central venous catheters, in which case the approach is likely the same as for a PD catheter.
I encourage clinicians to weigh in here on the balance of safety, practicality, and availability.
Dr. EFTEKHARI here in Broward has recommended that we sanitize masks In the dryer for five minutes on high heat, worth a try…if one is running low. I love the coffee filter/bandana suggestion. Thanks
You could try the Trump Administration, but doubt you’d get anywhere since you are an independent clinic. Have you tried asking any of the Davita clinics?
I read that the Service Employees International Union - United Healthcare Workers has contacted vendors across the country to find 39 million N95 masks. They’re connecting folks to those vendors. Here’s the story.
Here are CDC recommendations that may allow your clinic to extend the useful life of face masks.
I hadn’t heard of the dryer approach, but it’s interesting!
Where can I find evidence that 5 minutes in a dryer disinfects a disposable face mask? I couldn’t find that anywhere. I found a book published in 2006 entitled Reusability of Facemasks During an Influenza Pandemic: Facing the Flu at https://www.nap.edu/catalog/11637/reusability-of-facemasks-during-an-influenza-pandemic-facing-the-flu. In Chapter 3, it says “FDA and WHO recommend disposal of FDA-approved medical masks after one use by one patient (WHO, 2005; FDA, 2006) and that healthcare workers don a new medical mask or respirator each time they come into contact with a new patient (Lin, 2006). The agency states that washing disposable medical masks will destroy their barrier properties so that they will no longer prevent infection; thus, there is no way to disinfect disposable medical masks.” Since this was written several years ago, I’d suggest contacting the manufacturer of the mask to ask whether it’s possible to disinfect their mask. Better to be safe than sorry.