The Proper Way to Wear and Remove a Surgical Mask

Submitted by Dr. Stephanie Paulmeno, DNP, MS, RN, NHA, CPH, CCM, CDP

In these worrisome times we are seeing people walking about wearing different forms of medical masks in an attempt to protect themselves (or others) from the corona virus. Unfortunately the vast majority are wearing them improperly thus giving themselves and others a false sense of security. If you know a nurse, seek his or her guidance. Nurses are experts at infection control.

We see people with their noses exposed above their mask or wearing masks gaping open around the sides, top and bottom; others have not tightly squeezed the nose clip at the top of the mask; many pull masks up and down off their faces and the faces of their children. Used masks are contaminated items! Touching them contaminates your hands. Any of these actions or inactions negates any benefits you are hoping to achieve from wearing a mask. Breathing in a mask is uncomfortable but to gain the benefit of wearing one it must be worn properly. A surgical mask is just a barrier protection against breathing in droplets in the air directly around you. If you are not committed to wearing a mask properly, consider not using one at all; they are desperately needed by healthcare workers on the front line who will use them properly because they know their very lives depend upon it. The CDC does not recommend that the public who are well wear facemasks to protect against respiratory illnesses, including COVID-19.

If you are going to wear one anyway when you go out; here are some tips on how to properly apply, wear and remove a surgical face mask:

1. Properly and vigorously wash your hands before applying a mask and after removing one.

2. There is a top and a bottom to your mask. The top has a thin metal strip that must be squeezed tightly around the bridge of your nose.

3. Place the mask over your nose and mouth and secure the ties behind your head. Tie the top string tightly and high on the back of your head and the lower string tightly on the back of your head an inch or so below your ears (mid-neck). If you are using a mask with elastic bands, these are placed behind your ears and should be snuggly fit.

4. Once the mask is on and the wire over the bridge of your nose is squeezed securely, pull the mask fabric down under your chin and realign the edges of the mask fabric so that it is secure all around your face. This type of mask cannot form an airtight barrier; they just reduce droplet exposure. A mask that becomes moist from your own breathing becomes an ineffective barrier. Remember that your worn mask is contaminated so wash your hands after removing (or sanitizing or storing) a mask; something we would never have done prior to this protective barrier shortage.

An N-95 type of mask/respirator is a firm and molded product that filters the air you are breathing. To be effective it needs to fit tightly around YOUR face. Apply the straps as above and breathe in and out. If you can feel air leaking around your mask edges, it is not secure or not properly sized. Do not touch the outside of your used masks (any type); they are contaminated. Wash hands thoroughly after you remove, sanitize and/or store your mask.

Dr. Stephanie Paulmeno, DNP, MS, RN, NHA, CPH, CCM, CDP, is President of the Connecticut Nurses Association, President of Communities 4 Action and Chairman of The Patient is U Foundation, Inc.