To ensure it has enough personal protective equipment (PPE) to treat a second wave of COVID-19, the University Health Network (UHN) in Toronto has developed a process for reprocessing and storing N95 respirators for future use.
“We need to be prepared for any future shortages that may arise,” said AnnMarie Tyson, director of UHN’s Medical Devices Reprocessing Department (MDRD). “This system, as novel as it is, is something we can all feed confident in and proud of.”
The reprocessed respirators aren’t being used now, Tyson said, “but are being processed and then stored away by size and manufacturer type” should UHN need to access them.
As high-level protection for the nose and mouth, UHN said, N95 respirators only should be worn in healthcare settings. When used properly, they filter more than 95% of particles that may be present in the air, protecting healthcare workers from potential infections.
The demand for N95 respirators grew exponentially in the earlier stages of the pandemic, UHN said, creating uncertain supplies in many countries including Canada. UHN procurement efforts have guaranteed a minimum 3-day supply on hand, though UHN still wanted to be prepared.
“As a leading academic hospital, we have to think ahead and prepare for every scenario,” said Dr. Fayez Quereshy, interim vice president and site lead at Toronto General Hospital. “Among the many lessons to be learned during this pandemic, a very important one is that emergency preparedness is absolutely critical.”
N95 respirators originally were designed for single use, so reprocessing them was entirely new territory, UHN said.
“It’s something that has never been done before,” said Taylor.
“We’ve developed best practices in setting up our respirator reprocessing labs and continue to apply scientific rigor through testing and investigation as we build our program,” Taylor said.
“We are also collaborating with governing and regulatory bodies to guide our work, so we can be confident we have a safe process in place for storage and retrieval, if we need to,” Taylor said.
With approval from Health Canada and Ontario Health, and in consultation with suppliers, UHN has already reprocessed and stockpiled more than 2,300 N95 respirators of various sizes.
Given the unprecedented nature of this work, UHN said, there’s no set shelf life for the reprocessed respirators. Frequent tests are performed to assess their efficacy in case they are needed.
Staff wearing N95 respirators have been instructed to examine them when they take them off. If there are missing parts, broken bands, makeup residue, or any signs of bodily fluids, they are thrown away.
UHN has two respirator reprocessing labs, one at TGH and one at Toronto Western Hospital.
Once a respirator arrive at a lab, it goes through three inspection tables where it is further checked under a magnifying glass and light for visible gross soils and damage. If the respirator passes these inspections, it is considered a candidate for reprocessing.
The N95 is then packaged, sealed, and processed in the same machine used to sterilize delicate medical instruments. After the process is completed, the N95’s pouch is cracked open and allowed to aerate. The N95 then is resealed, labeled, stamped for quality control, and stored.