All of the caregivers in NURSING homes should have access to a mask N95?

Tous les soignants en CHSLD devraient-ils avoir accès à un masque N95?

Photo: Marie-France Coallier The Duty
The Fédération de la santé et des services sociaux (FSSS-CSN) claims since the start of the pandemic, N95 masks to its members in a CHSLD.

Doctors, who came to lend a hand in NURSING homes, be prohibited from wearing a mask N95 when they are working in ” hot zone “, with patients infected by the COVID-19. No question that there are “two weights two measures” within the troops, say CIUSSS. The clerks and nurses are currently masks procedure. There are voices that all caregivers have access to the N95.

The CIUSSS of the West-of-the-Island-of-Montreal has sent a memo on April 18, the doctors volunteered to work in a CHSLD. The Directorate of professional services (DSP) indicates that the port on the N95 is ” necessary in generating medical procedures aerosol-only “. However, continues the DSP, the intubations are rare in a CHSLD. “It is therefore prohibited for doctors to wear the mask N95 for their medical visits [in bold in the text], because this generates anxiety important among the staff, ” she concludes, in its note of service.

The CIUSSS du Centre-Sud-de-l’île-de-Montréal shares this position. “We don’t want to have a double standard between the professionals,” explains Dr. Sophie Zhang, co-head deputy of the accommodation. The CIUSSS said to follow the instructions of the Institut national de santé publique du Québec (INSPQ) to protect its staff. The INSPQ recommends that the port of the N95 in medical procedures generating aerosols, such as intubation and suctioning of secretions in a patient with a tracheostomy.

Dr. Julie Choquet door the majority of the time, a mask process and a visor when it is going to help in a CHSLD. But it sometimes takes a N95, when it deems necessary, she said. It is yet forbidden by his CIUSSS. “I will not stop to put an N95,” said the family doctor, who works at the hospital in LaSalle. Dr. Julie Choquet account the wear if a patient is in significant respiratory distress. She fears a greater contagiousness in this situation. “We don’t study [which shows], but it made me chicote. “


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The issue of the mode of transmission

Many unknowns remain about the mode of transmission of the COVID-19. The virus seems to especially be transmitted through droplets during a prolonged close contact or through direct contact when a person coughs, say the authorities. The transmission, by surfaces or objects contaminated, is possible. With respect to the transmission by aerosols (small droplets that can remain suspended longer in the air), it is the subject of controversy.

“Many scientists, including myself, believe that the aerosols have a role to play in the transmission,” said Dr. Raymond Tellier, a microbiologist at McGill university health Centre. Caregivers in NURSING homes should wear, in this case, a N95 ? “It is very possible,” he replied.

Dr. Serge Keverian, who works at the emergency of the Jean-Talon hospital in Montreal, argues that all health professionals in NURSING homes have access to a mask, N95. He has recently given a helping hand in a ltc facility where more than half of the residents are infected.

“The government says that all the world should be at two meters of distance to avoid being transmit the virus,” said Dr. Serge Keverian. We are told that an attendant, who spends 10 minutes with a patient, is quite protected with a mask procedure. I find it ridiculous. “It is argued that the affected residents of the coronavirus in CHSLDS are not hidden, in contrast to patients in the hospital environment. A barrier of less, ” he said, between the virus and the caregiver.

His colleague, Dr. Myra Lemelin has chosen to continue to work to the emergency room of the Jean-Talon hospital, rather than go to help in a CHSLD. “One of my fears is to catch the COVID-19, said the family doctor. This is not for me, but for the team. The third of our group of physicians is now in a CHSLD. If I have to put myself in quarantine, it’s going to have an impact. “

According to it, all of the caregivers — in the first place, the charge to the beneficiaries — should wear a surgical mask N95. “The employees are pasted on the patient,” she said. The care (changing diapers, toileting, etc) last more than ten minutes. “What are the professional that are the most exposed “, says she.

Last week, Dr. Gaétan Barrette plays the role of an attendant and licensed practical nurse in a CHSLD Champlain in Brossard. He feeds for patients in a safe, uncontaminated area. “Me, I always take the patient who puts the most time to eat,” said the liberal mp and former minister of Health. It takes an hour. I wear a visor, a mask of a procedure and gloves. I’m not worried. The person is negative. “

It would be otherwise if the resident was suffering from the COVID-19, ” said Dr. Gaétan Barrette, who does not share the government’s position in this chapter. “I can guarantee you that I would wear my N95. I am in front of the patient, in the flow of air. “

The Fédération de la santé et des services sociaux (FSSS-CSN) claims since the start of the pandemic, N95 masks to its members in a CHSLD. “It takes the best equipment possible to ensure they do not spread the virus “, said its president, Jeff Begley.

According to the FSSS-CSN, the access to the personal protective equipment that improves in a CHSLD. Employees have access to masks procedure, gowns and gloves. “You start to find there visors,” adds Jeff Begley. Employees in certain NURSING homes also have access to N95 masks, ” he said. “There are employers who, if they have enough in stock, give, said Jeff Begley. It started quietly. “

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