COVID-19 Information for the Otorhinolaryngology Community

Elastomeric Respirators: Alternative to Disposable N95 Respirators

During the COVID-19 pandemic, disposable N95 respirators are in short supply; however, such PPE is necessary during all aerosol generating procedures (AGPs). Routine office ENT procedures, including fiberoptic laryngoscopy and nasal endoscopy (with and without debridement), are indeed AGPs. In addition, commmon ENT operating room procedures have also been associated with a risk of inadvertent COVID-19 virus transmission. Thus, the search for alternatives to the traditional medical-grade N95 respirator has begun with some urgency.

Elastomeric respirators are re-usable respirators originally designed for industrial applications. These devices, if successfully fit-tested for the wearer and used properly, offer protection that exceeds the protection of traditional medical N95 respirator masks. In partnership with UTHealth Environmental Health & Safety, all attending physicians and resident physicians were fit-tested and trained for a half-face elastomeric respirator. Training included a vigorous disinfection protocol to ensure that the elastomeric respirator can be decontaminated between each use. Each physician has been given an elastomeric respirator for use in the clinic and hospital settings.

It should be noted that while the elastomeric respirator offers excellent protection to its wearer, it does not protect the patient. Thus, a standard surgical mask should be used in conjunction with the elastomeric respirator. The surgical mask also offers some protection of the respirator against visible contamination.

Many different models of elastomeric respirators are available. Government standards are quite specific and each device should carry these regulatory ratings. At UTHealth ORL, these models are in use, although many other models will offer comparable features:

Representative elastomeric respirator: Honeywell Half Mask Respirator
Representative filter cartridge: Honeywell P100 Filter

Important Links
Resuable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use
CDC/NIOSH-Approved Elastomeric Respirators with P100 Filters (Brittany E. Howard, MD)
UTHealth Environmental Health & Safety Elastomeric Respirator Disinfection SOP

Otorhinolaryngolology Procedures: High Risk for Inadvertent COVID-19 Transmission?

Precautions for Endoscopic Transnasal Skull Base Surgery During the COVID-19 Pandemic (Zara M Patel, MD; Juan Fernandez-Miranda, MD; Peter H Hwang, MD; Jayakar V Nayak, MD, PhD; Robert Dodd, MD, PhD; Hamed Sajjadi, MD; Robert K Jackler, MD)

COVID-19 and Ear Surgery (Robert K. Jackler, MD)

Update on Precautions Regarding Endoscopic Procedures & COVID-19 (Zara M. Patel, MD; Peter H. Hwang, MD; Jayakar V. Nayak, MD, PhD; Juan Fernandez-Miranda, MD; Robert Dodd, MD, PhD; Hamed Sajjadi, MD; Robert K. Jackler, MD)

Report from the Stanford Endoscopic Sinus & Skull Base Team (Zara M. Patel, MD; Peter H. Hwang, MD; Jayakar V. Nayak, MD, PhD; Juan Fernandez-Miranda, MD; Robert Dodd, MD, PhD; Hamed Sajjadi, MD; Robert K. Jackler, MD)

Retracing the Path of Contagion Arising From the “Super-Spreader” (Andy Chua, MD)