Hines, Stella E.THURMAN, PAULMcDiarmid, Melissa A.2021-02-232021-02-232021-02-03http://hdl.handle.net/10713/14748This document serves as a guide to support implementation of elastomeric respirator-based respiratory protection programs in healthcare settings. Based on best practices employed in hospital and ambulatory practices at the University of Maryland-Baltimore, the guide includes background evidence, logistics on fit-testing, distribution and decontamination, and a summary of cost estimates associated with this form of respiratory protection. The guide includes tools like Information Sheets, checklists, training tools and photos to help other programs set up their own programs.Elastomeric half mask respirators (EHMRs) provide similar or higher level of protection as do N95 filtering facepiece respirators (N95 FFRs) and are designed to be reused. Supply chain shortages of respirators at the onset of COVID-19 surge prompted a large, urban, US academic medical center to rapidly expand use of EHMRs. A scaled fit-testing operation completed over 7000 fit-tests over six weeks. A centralized EHMR decontamination program was established in the Central Sterile Processing department. EHMR users obtained and returned their respirators each day from a central distribution center using a shared-supply model. This EHMR-based model of respiratory protection was cost effective. All healthcare personnel that needed respiratory protection during COVID-19 surge had access to NIOSH-approved, employer-provided respirators.I. Contents ii II. Abbreviations v III. Table of Figures vii IV. Executive Summary 1 V. Background 5 VI. Determinants of User Device Assignments 14 VII. Fit-testing Program 17 VIII. Logistics 25 IX. Responsibilities of Key Program Leaders 37 X. Costs 40 XI. References 45 XII. Appendices 52 XIII. Acknowledgments 91Attribution-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nd/4.0/elastomeric respiratorN95respiratory protectionpandemichospitaldecontaminationpersonal protective equipmentNo