AORN, ASA, and APSF Clarification of Powered Air-Purifying Respirator (PAPR) Use in the Operating Room and Other Procedural Areas in Which Sterile Fields are Present

A number of facilities in the US were misinterpreting the AORN guidelines on PAPR use and denying anesthesia professionals and other operating personnel who failed to be satisfactorily fit-tested with N-95 masks the opportunity to use PAPRs. The concern has been that the air flowing from the PAPRs can cause micro-organisms to flow onto sterile fields. In fact, there are studies to show that does not occur.

The clarification will help those who are unable to be fit-tested and give them the option of using PAPR technology in the ORs.

Clarification of PAPR use in the Operating Rooms

When an N95 cannot be properly fit tested for use by healthcare personnel in the operating rooms and other invasive procedure areas or an N95 is not available for urgent/emergent procedures, we recommend that an interdisciplinary team including infection control, nursing, surgery and anesthesia personnel determine how PAPRs may be most safely used for respiratory protection in the perioperative environment when a sterile field is present.¹

Each health care facility or system should develop a standardized procedure for perioperative PAPR use and protection of the sterile field from contamination, (e.g., identify portions of the sterile field to be covered; direction of the blower exhaust; and type of PAPR allowed, such as loose-fitting, full face piece, or hood style).¹

1. Guideline for sterile technique. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2020e.

Disclaimer: Viewers of this material should review the information contained within it with appropriate medical and legal counsel and make their own determinations as to relevance to their particular practice setting and compliance with state and federal laws and regulations. The APSF has used its best efforts to provide accurate information. However, this material is provided only for informational purposes and does not constitute medical or legal advice. This response also should not be construed as representing APSF endorsement or policy (unless otherwise stated), making clinical recommendations, or substituting for the judgment of a physician and consultation with independent legal counsel.