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Page 1: Quick Reference Guide Prevention & Management of Skin ... · 3M N95 Aura OS 1870+ Thin hydrocolloid 3M N95 1860S DO NOT use dressing 3M N95 1860 DO NOT use dressing 3M N95 Vflex S

Sept. 2, 2020 Prevention and Management of Skin Injury from PPE 1

Quick Reference Guide Prevention & Management of Skin Injury from Personal Protective Equipment

(PPE)

Prevention of Skin Injury (See product examples on Page 2) PPE selection: Use the PPE appropriate to Zone (Red, Orange, or Green) Skin Care at Home: Hands: Apply moisturizer or barrier cream with Dimethicone, silicone, ceramides or ointment with petrolatum*. *Avoid use of petrolatum based hand lotion when using latex gloves Face: Prevent/treat acne breakouts by washing face with pH balanced soap & moisturizing. Avoid application of make-up over affected areas. Skin Care at Work: Pressure relief: Remove PPE to relieve pressure on the skin appropriate to Zone. If a dressing is used, leave in place if intact until end of shift. Consider a holding device or dressing to relieve pressure behind ears. Skin inspection end of shift: Upon removal of PPE, & protective dressing if in place, inspect skin for injury or irritation. Once at home after proper hand washing, face & neck should be thoroughly cleansed using pH balanced soap & water. Dry face & neck, moisturize hands & face. Surgical Masks: Do not apply undue pressure when applying PPE, while still ensuring a tight seal. N95 Respirators: Consider a dressing if indicated in chart below. Management of Skin Injury 1. Report skin injury or irritation as per site work related injury/illness process to Occupational Health or

designate 2. Do not rub any areas which may have been under pressure, as this may increase damage. 3. Do not apply moisturizer over areas of skin breakdown, consider a dressing.

Hands at home Hands at work: Moisture & Irritation from Gloves Contact Occupational Health or designate

Prevention & Treatment Prevention Treatment Use mild pH balanced soap Regular & frequent application of moisturizer

Dry hands thoroughly Avoid jewelry & wrist watches Barrier wipe Moisturizer

Barrier wipe Moisturizer

Face: Surgical Masks, Goggles, Eye & Face Shields, N95 Respirators, Half Mask Respirators Contact Occupational Health or designate

Level of Skin Injury

Surgical mask, goggles, eye & face shield

N95 Respirator

Intact skin - Redness prevention

Barrier wipe Barrier wipe

Intact skin - Non blanchable redness persists (Stage 1 Pressure Injury)

See Page 3 for dressing placement Thin hydrocolloid sheet or Thin non-bordered silicone foam

Barrier wipe See list of mask types on Page 2 for dressing compatibility See Page 3 for dressing placement

Skin breakdown - Blister open or intact (Stage 2 Pressure Injury)

Bordered thin silicone foam dressing

Contact Occupational Health or designate

Page 2: Quick Reference Guide Prevention & Management of Skin ... · 3M N95 Aura OS 1870+ Thin hydrocolloid 3M N95 1860S DO NOT use dressing 3M N95 1860 DO NOT use dressing 3M N95 Vflex S

Sept. 2, 2020 Prevention and Management of Skin Injury from PPE 2

N95 Respirator Type Possible solutions

Remind staff they must check the seal each time they don a respirator by performing a user seal check. 3M N95 Aura OS 1870+

DO NOT use dressing

3M N95 1860S DO NOT use dressing

3M N95 1860 DO NOT use dressing

3M N95 Vflex S 1804S

DO NOT use dressing

3M N95 Vflex Reg. 1804

DO NOT use dressing

3M N95 8210 DO NOT use dressing

AO Safety N95 PleatsPlus S/M

Thin non-bordered silicone foam

AO Safety N95 PleatsPlus M/L

Thin non-bordered silicone foam

Kimberly Clark N95 Small

DO NOT use dressing

Kimberly Clark N95 Regular

DO NOT use dressing

Moldex N95 OS DO NOT use dressing

North 7130 Small Thin non-bordered silicone foam

North 7130 Regular DO NOT use dressing

1/2Mask 7501 S Adjust top straps first, & then lower neck straps by pulling on ends. DO NOT over-tighten. Strap tension may be decreased by pushing out on back side of buckles. DO NOT use dressing

1/2Mask 7502 M

1/2Mask 7503 L

1/2Mask 6501 S

1/2Mask 6300 L

Product Category Product Suggestions

Barrier Wipe 1ml 3M™ Cavilon™ No Sting Barrier Wipe 1ml No-Sting™ Skin-Prep protective wipe

Hydrocolloid 15x15cm Comfeel ® Plus Transparent 14x14cm Duoderm® Extra thin hydrocolloid

Thin non-bordered silicone foam

15x15cm Mepilex® Lite

Bordered foam 4x5cm Mepilex ®Border Lite

Important tips Barrier film must be allowed to dry for 1 minute before donning PPE Dressings should not be stretched but gently molded to fit contours of nose and cheeks. Hydrocolloids are adhesive and must be removed gently, holding skin below Thin non-bordered silicone foam has a low tack (gentle adhesive) to hold in place

Nose and cheeks

Forehead

Ears: Note 1cm might be too small for good fit see template on Page 4

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Sept. 2, 2020 Prevention and Management of Skin Injury from PPE 3

Goggles eye & face shields Thin hydrocolloid or Thin non-bordered silicone foam

Surgical mask & specified N95 respirators Thin hydrocolloid or Thin non-bordered silicone foam

Surgical mask Holding device

Surgical mask Thin hydrocolloid or Thin non-bordered silicone foam

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Sept. 2, 2020 Prevention and Management of Skin Injury from PPE 4

Dressing templates (actual size)

Forehead

Nose and cheeks

Ear Ear

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Sept. 2, 2020 Prevention and Management of Skin Injury from PPE 5

Premise of document This document was developed by Kari Mann CNS for Skin and Wound at Health Sciences Centre and Jane McSwiggan Education and Research Coordinator, Winnipeg Regional Health Authority (WRHA) in response to the development of staff skin injuries from the use of personal protective devices (PPEs) being worn on the face and irritation to hands from gloves . Using materials and documents produced by Nurses Specialized in Ostomy and Continence Nursing Canada (NSWOC), APTFeridas, the Portuguese Wound Care Association, the National Pressure Injury Advisory Panel (NPIAP), and in consultation with Darren Nowakowski, Safety Coordinator, WRHA Occupational and Environmental, Health & Safety it was determined that N95 respirators should be fit tested with dressings to see if a seal can be achieved. As per current practice, staff must still perform a proper positive and negative seal check after each donning to ensure protection. The listed N95 respirators have been fit tested quantitatively using Portacount Pro Plus model 8038. It is important to note that a respirator which did not seal with a dressing also did not seal without a dressing, therefore a different model of respirator had to be fitted. Of note, the thin hydrocolloid and thin non-bordered silicone foam dressing are very thin and flexible dressings which easily conform to the face. References

Alves, P., Moura, A., Vaz, A., Ferreira, A., Malcato, E, Mota, E. et al. (2020). PRPPE guideline Covid 19:

Prevention of skin lesions caused by personal protective equipment. [White Paper]. Journal of Tissue Healing and Regeneration. Retrieved from https://dsr.dk/sites/default/files/50/recomendation_prppe_covid19_ing_1.pdf

LeBlanc, K., Heerschap, C., Butt, B., Bresnai-Harris, J., & Wiesenfeld, L. (2020). Prevention and management

of personal protective equipment skin Injury: Update 2020, NSWOCC. Retrieved from www.nswoc.ca/ppe.

National Pressure Injury Advisory Panel. (2020). NPIAP position statements on preventing injury with N95 masks. Retrieved from https://cdn.ymaws.com/npiap.com/resource/resmgr/position_statements/Mask_Position_Paper_FINAL_fo.pdf


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