Optimizing Face Mask Protection Through Proper Sizing, Fit, and Use

Masks are an excellent example of how external factors can impact the performance of personal protective equipment (PPE) and why having a thorough understanding of best practices is critical to preventing the spread of infectious diseases and other common threats in the healthcare environment.

While exact fit and usage requirements will vary slightly depending on the model and design of the medical mask you intend to use, these tips should apply to most standard ASTM-rated single-use medical masks.

Mask Sizing Considerations

Unlike some PPE, most procedure masks and surgical masks are offered in a universal size designed to fit a range of face shapes and account for most common facial characteristics.

Pediatric medical masks are an exception to this trend. Many feature smaller designs and earloops to help ensure a snug fit on smaller faces.

Keep in mind that patterns and other visual design features are not an indicator of size. For example, PRIMED offers a dinosaur pattern procedure mask in both universal and pediatric formats. So always check your product’s packaging or marketing materials to ensure you’re choosing the ideal mask for your intended use.

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Finding the Perfect Medical Mask Fit

While some respirators might require more complex sizing and fitting considerations, checking for a proper fit with procedure or surgical masks is straightforward.

In general, there should be no gaps along the side, around the nose or under the chin that would allow air and droplets to bypass the filter medium.

In doing so, the mask should fully cover both the mouth and nose. It should also stay in place over the nose and cheeks. When fit properly, even standard masks will prevent eyeglass fogging during use.

Choosing a mask design with a nose piece can help to further improve a mask’s seal around the nose and cheeks.

Masks should not sit away from the face, be worn with the nose exposed, or dangle around the neck. Masks should exist in one of two states: fully donned or disposed of.

Proper Donning of Ear Loop Procedure Masks

How you put on and remove your single-use medical mask (also known as donning and doffing) is essential to optimizing fit and ensuring maximum protection. Failure to properly don or doff your mask could lead to mask or environmental contamination, possible spread of pathogens, or compromise of the mask’s protective and filtration abilities.

The following steps are recommended for all earloop masks — such as PRIMED ASTM-rated procedure masks.

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Step 1: Thoroughly wash and dry your hands.

Cleaning your hands ensures that you do not contaminate the mask and also helps to reduce the risk of spreading infection when placing your hands close to your face during the donning process.

Drying your hands is as important as washing. Damp masks may not perform as rated. Depending on the textiles used, dampness might also compromise durability.

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Step 2: Remove the mask from its packaging. Hold the mask with the nose wire at the top and the outer layer out.

In most cases, the outer side will be the coloured surface of the mask. If the mask is not coloured, the side with more texture is often the outer facing layer.

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Step 3: With the pleats folding down, pull to open the pleats.

Be sure to grip the mask on the upper and lower borders and minimize the amount of time you spend handling the filtration surfaces of the mask. This will ensure the mask remains clean and dry, offering the highest level of protection for its rating.

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Step 4: Bring the mask to your face. Press the metal nose piece to the bridge of your nose to shape the mask.

The mask should closely follow the contours of the bridge of your nose and your cheeks. It is not critical to get an airtight seal at this stage. However, establishing the proper shape is essential to maximizing closure once the mask is fully donned.

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Step 5: Pull the ear loops over your ears.

Place your fingers through the ear loops and pull them back and secure them behind your ears. Avoid touching your face and hair where possible, allowing the strap to gently snap in place.

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Step 6: Press the nosepiece again to ensure a secure fit.

With the ear loops in place, press again on the nosepiece to finalize the fit. When you are done, the mask should rest gently against the face, minimizing air leakage.

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Proper Doffing of Ear Loop Procedure Masks

Step 1: Thoroughly wash and dry your hands.

Any time that you reach toward your face, you should be sure to clean your hands first.

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Step 2: Pull the ear loops back over your ears taking care to avoid touching other parts of the mask.

Avoid touching your face where possible by running your finger underneath the elastic strap near the rear of your ear. Pulling the straps away from your head before removing the mask in a forward motion, minimizes mask movement and rotation. This reduces the risk of contact between contaminated mask surfaces and skin.

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Step 3: Dispose of the mask immediately to prevent further risk of contamination.

Be sure to dispose of your used mask according to regulatory requirements or standard operating procedures for your healthcare facility. This will reduce the risk of environmental contamination and ensure that you never accidentally reuse a potentially contaminated mask.

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NOTE: Our instructional video outlines the process of donning and doffing a single-use ear loop face mask from start to finish.

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Proper Donning of Surgical Tie Masks

Surgical tie-on masks work similarly to ear loop designs. However, you’ll need to adjust your donning and doffing methods to account for the ties used to secure the mask.

NOTE: It’s also important to consider the order in which you don your PPE when using surgical tie-on masks. If using the mask with a surgical cap or a bouffant cap, be sure to don the cap first to reduce the risk of the mask’s tie-on straps slipping on hair and causing an insecure fit.

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Step 1: Thoroughly wash and dry your hands.

Cleaning your hands ensures that you do not contaminate the mask and also helps to reduce the risk of spreading infection when placing your hands close to your face during the donning process.

Drying your hands is as important as washing. Damp masks may not perform as rated. Depending on the textiles used, dampness might also compromise durability.

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Step 2: Remove the mask from the packaging. Hold the mask with the nose wire at the top and the outer layer out.

In most cases, the outer side will be the coloured surface of the mask. If the mask is not coloured, the side with more texture is often the outer facing layer.

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Step 3: With the pleats folding down, grasp the top of the mask at the center of the metal nose piece. Pull the bottom edge of the mask to open the pleats.

Be sure to grip the mask on the upper and lower borders and minimize the amount of time you spend handling the filtration surfaces of the mask. This will ensure the mask remains clean and dry, offering the highest level of protection for its rating.

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Step 4: Place the mask against your face with the nose piece centered on the bridge of your nose. Press the nose piece to the bridge of your nose and along your cheekbones to shape the mask to your face.

The mask should closely follow the contours of the bridge of your nose and your cheeks. It is not critical to get an airtight seal at this stage. However, establishing the proper shape is essential to maximizing closure once the mask is fully donned.

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Step 5a: Take the top ties (one in each hand) and pull them toward the crown of your head. Tie the upper ties with enough tension to hold the mask firmly against your face.

Ties should rest on top of any head covering to minimize slipping and ensure a snug fit throughout the procedure or while moving throughout the environment. If you’re using a horizontal tie mask, the top tie should sit at the back of your head.

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Step 5b: Repeat the tying process with the lower ties, routing the ties underneath your ear and securing them behind your neck.

At this point, the mask should fully cover the mouth, chin, cheekbones, and nose. The mask should remain firmly in place when moving, bending, or speaking.

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Step 6: Press the nose wire firmly against your face again and ensure an optimal seal across the bridge of your nose and upper cheekbones.

This final pressing of the nose piece will ensure an optimal fit and minimize any air gaps between the cheekbones or nose and the top of the mask. Use firm pressure to adapt the mask to your face.

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Proper Doffing of Single-Use Surgical Tie Masks

Step 1: Thoroughly wash and dry your hands.

Any time that you reach toward your face, you should be sure to clean your hands first.

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Step 2a: Release the mask by breaking or untying the bottom tie followed by the top tie.

Step 2b: Holding the mask by the ties, pull it away from your face.

Pull the mask straight away from your face. Avoid touching any of the mask surfaces or jostling the mask with any unneeded twisting or shaking.

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Step 3: Dispose of the mask immediately to prevent further risk of contamination.

Be sure to dispose of your used mask according to regulatory requirements or standard operating procedures for your healthcare facility. This will reduce the risk of environmental contamination and ensure that you never accidentally reuse a potentially contaminated mask.

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NOTE: Our instructional video outlines the process of donning and doffing a single-use surgical tie face mask from start to finish.

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Summary

• By choosing the proper face mask and following the proper donning and doffing steps for your mask’s design, you can improve the safety of both healthcare professionals and patients alike.
• Both fit and mask choice are equally important in preventing the spread of infectious disease. The wrong mask worn properly or the proper mask worn incorrectly will both offer less protection than the proper mask worn correctly.
• Always minimize contact with mask surfaces during donning and doffing. Starting the donning and doffing processes with clean hands can further reduce the risk of contamination.
• When fit properly, there should be minimal gaps along the side, around the nose, or under the chin to prevent air and droplets from bypassing the filter medium.

PRIMED’s range of ASTM-rated single-use medical masks offers high quality protection for healthcare professionals and patients. From classic and high-filtration models to masks with anti-fog tape, foam, or film, our masks are designed to provide effective protection, optimal comfort, and reliable quality. Contact PRIMED today to learn more about our selection of industry-leading mask options.