Correct Way to Wear a Surgical Mask
Surgical masks should be worn to cover both the nose and mouth completely, changed when they become wet or soiled, and positioned tightly enough to minimize leakage around the face edges. 1
Proper Mask Positioning and Fit
The mask must cover the mucous membranes of the eyes, nose, and mouth during procedures likely to generate splashing or spattering of blood or body fluids. 1
Position the mask to fit snugly against the face, minimizing gaps between the mask material and facial contours, as poor positioning and leakage significantly reduce effectiveness. 1
Ensure the mask is sufficiently tightened around the face to prevent air leakage, as masks that are not properly secured show reduced protection against microorganism transmission. 1
Type of Mask Selection
Use a type II or IIR medical mask (standard CSN EN 14683:2019) in healthcare settings, as this provides adequate bacterial filtration efficiency for routine clinical care. 1
For high-risk aerosol-generating procedures (intubation, extubation, supraglottic airway insertion/removal), upgrade to a fit-tested N95 or FFP2 respirator instead of a surgical mask, regardless of patient COVID-19 status. 1
When to Change Masks
Change masks between patients or during patient treatment if the mask becomes wet, as moisture significantly reduces filtration efficiency and increases contamination risk. 1
Replace masks immediately when they show traces of biological fluid projections, as bacterial contamination increases significantly over time, particularly after 2-4 hours of continuous wear. 1
Change masks when they become visibly soiled or damaged during use. 1
Hand Hygiene Protocol
Perform hand hygiene with alcohol-based hand rub or soap and water immediately before donning the mask. 1
Wash hands immediately after removing the mask to prevent transfer of microorganisms. 1
Avoid touching the mask surface during wear, as this can transfer contaminants to hands or compromise the mask's position. 1
Sequence of PPE Donning and Removal
When full PPE is required, don the mask after performing hand hygiene but before donning gloves. 1
During PPE removal, remove gloves first, followed by eye protection, then the gown, and finally the mask, to prevent contamination during the removal sequence. 2
Remove all barrier protection including the mask before departing the work area (patient care, instrument processing, or laboratory areas). 1
Common Pitfalls to Avoid
Do not wear the mask below the nose or with gaps around the edges, as this defeats the primary purpose of containing respiratory droplets and protecting mucous membranes. 1
Never reuse single-use disposable surgical masks, as contamination accumulates on the mask surface over time. 1
Avoid adjusting or touching the mask during patient care, as this can transfer pathogens from the mask surface to hands or vice versa. 1
Do not continue wearing a mask that has become damp from exhaled moisture, as wet masks lose their barrier effectiveness and may actually increase transmission risk. 1
Additional Considerations for Enhanced Protection
When wearing a basic surgical mask in high-risk situations where N95 masks are unavailable, consider using a mask brace or securing device to improve face seal and reduce air leakage around the edges. 3
Combine mask use with eye protection (safety goggles or face shield with solid side shields) during any procedure with splash or spatter risk. 1
Maintain physical distancing of at least 1-2 meters from others when not actively providing patient care, even when masked. 1