Opinion piece on wearing a positive pressure hood.
Back at the beginning of lockdown, I failed my first FFP3 respirator fit test. However, at that stage, my daughter had just returned from London to stay with us and she was shielding so there was no question of me treating patients face to face at our practice which had become a UDCC so I set to triaging.
However, two weeks ago she was lifted out of shielding which coincided with the transition to recovery for the practice so I was able to be fit tested again.
It was another failure. Admittedly, I’m only 1.54 m tall and weigh fifty-three kilos so I’m quite small, but whether you can achieve a good seal is more to do with the shape of your face and cheekbones than your height.
However, we had a wonderful fit tester (Darren Duncan from Surrey Safety)
who had endless patience and produced a P3 half mask for me to try. Unfortunately, it was another failure for me due to my face being too small again.
These are relatively inexpensive, though, at approximately £22 and are reuseable – the filters will require changing but I understand it’s monthly so we did subsequently purchase some for a couple of our nurses who failed their fit tests. Speech is very muffled through these respirators,however, so none of the dentists opted to wear them due to the potential communication problems with patients. Added to which they look quite scary.
Finally, Darren suggested that the one thing that would work for me and wouldn’t require a fit test was a positive pressure hood.
I had no idea what this was but five hours later, I had more knowledge than I care to admit on the various types available on the market and I started to narrow them down.
The one which really appealed to me was the Perso hood being developed by Southampton University
and being manufactured by Baynham.
Baynham were very responsive to my emails, but unfortunately, they couldn’t give me a date on when they would be available for sale to individuals (rather than NHS Trusts who were being prioritised for delivery).
I didn’t want to take the risk of my hood being delayed so I decided to go with the JSP Jetstream Switch and Go 8-hour multi plug respirator hood. It’s belt mounted and rechargeable.
JSP were very helpful when I spoke to them on the phone and they assured me the hood gave me the same protection as an FFP3 mask. I ordered one – with a spare hood (Darren had advised me to do that so I could disinfect one between patients). JSP informed me that the filter would last for at least 12 months – but were we going to have a vaccine by then I mused so I bought a spare filter, too, just in case.
The cost of the unit, a spare hood and the extra filter was £331 without VAT from Sitebox Ltd.
It all arrived in a large plastic carrying case the very next day and after initially being concerned that the visor looked opaque, I realised it had removable film inside and out and was actually very clear. I tried it on and it needed a bit of fiddling with the interior Velcro adjustable headband, (again due to my size), but after some simple sewing I could wear it with my loupes and wireless light.
It felt more comfortable than the FFP3 mask as your face is flooded with cool air and there is no tight fit. The filter is supplied on a Velcro waist band and weighs 765g. It’s quite big and makes a whirring sound when switched on, but the noise is not intrusive and you can both hear and be heard easily.
The Big Day came today when I wore it to treat patients for the first time.
My overall impression was that it was okay and relatively comfortable. My vision was fine, but it’s trickier to get on over my loupes than I first thought and I found that after a full day my loupes hurt over my ears. I also learned to push my fringe up and clip it out of the way because otherwise the internal head band squashes your hair down into your eyes. Like all respirator masks, you have to give yourself some normal air breathing every hour, but that wasn’t difficult to achieve and the nylon hood is disconnected from the waist belt and left in the surgery to be cleaned with a Clinell after seeing a patient.
Whilst I may look like a Smurf (because the hood fills with air), my patients didn’t seem too bothered by my appearance.
Most of my colleagues are wearing FFP3 masks, but they aren’t that comfortable after a few hours either and when the sheer size of an FFP3 dwarfs your face, I think the respirator hoods are a good alternative- and at the current cost of FFP3’s, they may well be more cost effective depending on how long the Covid crisis lasts.
I don’t think wearing any Level 3 PPE is comfortable, but at least I do feel safe and it’s good to be back treating patients once again.
9th June 2020 – LDC Member – Claudia Peace
COVID-19 PPE Information
The following information is for BDA Indemnity policyholders. Members who have cover with other providers should seek confirmation there.
To provide the necessary protection respiratory protective equipment (RPE) masks need to be fit-tested by a competent person.
Fit testing is an essential part of safe dental practice and it is covered under the definition of dental services in our BDA Indemnity policy.
The policy allows policyholders to fit-test dental staff in their own and other practices.
The practice owner’s BDA Indemnity policy will cover an employee in their own practice to do fit testing. The employee should be trained to the standards set our below. The employee can provide fit testing for the practice’s staff only.
Policyholders wishing to become fit testers should be trained to the standards set by the BSIF (British Safety Industry Federation) and be accredited as a fit test tester for RPE. They should maintain their competence by regular refresher training and updates and maintain records of training as part of CPD.
Fit Testers Directory
Here are the inks to the British Safety Industry Federation’s ‘fit2fit’ initiative;
Home – https://www.fit2fit.org/ – You will note the dental reference now added to this page!!
Directory of 387 fit testers – https://www.fit2fit.org/find-a-tester/
Approved training providers here – https://www.fit2fit.org/fit2fit-approved-training-providers/
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