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701EastMarshallStreet Westchester,Pennsylvania19380 610.431.5000 ChesterCountyHospital.org HealthcareWorkerRespiratorMedicalEvaluationQuestionnaire AdaptedfromTitle29,CodeofFederalRegulations, OccupationalSafetyand
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How to fill out notesinceformn95maskusedaspersonalprotectionwhencaringforknown
How to fill out notesinceformn95maskusedaspersonalprotectionwhencaringforknown
01
Start by reading the instructions provided with the N95 mask.
02
Make sure your hands are clean before handling the mask.
03
Fully unfold the mask and hold it over your nose and mouth, with the nosepiece at the top.
04
Secure the mask straps behind your ears or head, ensuring a snug fit.
05
Use both hands to mold the nosepiece to the shape of your nose, ensuring a tight seal.
06
Perform a fit check by inhaling sharply to check for air leaks around the edges of the mask.
07
Once the mask is properly fitted, avoid touching it while wearing.
08
When removing the mask, grasp the straps and carefully remove it without touching the front surface.
09
Dispose of the used mask in a proper waste container.
10
Clean your hands thoroughly after removing the mask.
Who needs notesinceformn95maskusedaspersonalprotectionwhencaringforknown?
01
Healthcare workers and medical professionals who are caring for known COVID-19 patients.
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What is notesinceformn95maskusedaspersonalprotectionwhencaringforknown?
This form is used to report the use of N95 masks for personal protection when caring for individuals known to be infected.
Who is required to file notesinceformn95maskusedaspersonalprotectionwhencaringforknown?
Healthcare workers, caregivers, and individuals providing direct care to known infected individuals are required to file this form.
How to fill out notesinceformn95maskusedaspersonalprotectionwhencaringforknown?
The form must be filled out with details of when and where the N95 masks were used, as well as the duration of exposure to the infected individual.
What is the purpose of notesinceformn95maskusedaspersonalprotectionwhencaringforknown?
The purpose of this form is to track and monitor the use of N95 masks for personal protection in healthcare settings.
What information must be reported on notesinceformn95maskusedaspersonalprotectionwhencaringforknown?
The form must include details such as date and time of mask use, patient information, and any symptoms observed in the infected individual.
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