Module 2: Breathing with

Importance of having the correct type of mask and size

• During the initial fitting, the user will try various masks to find the one most comfortable for him/her.
• A stencil/size chart is available for most masks, which can be a help when finding the right size.
• The mask must fit well and feel comfortable.
• It must not pinch the nostrils together and the pressure should be evenly distributed across the face.
• Most masks are now supplied with a guide on how to put the mask on the face and techniques for proper tightening of the straps to prevent leakage and pressure.
• Many demonstration videos can also be found on YouTube and mask supplier web sites. See the examples below under Mask instructions and videos.

Headband

Some masks have a headband. This is to reduce the pressure on the bridge of the nose and to stabilise the mask on the face.

• The headband is adjustable on many masks
• Start with as much angulation of the headband as possible. This provides the best pressure relief on the bridge of the nose. Adjust it inwards if air leaks into the eyes.
• Adjust the straps after adjusting the headband.

Mask straps/cap

The straps of the mask/cap must also be the correct size to obtain the right tightness and to prevent the straps from chafing.

• Make sure the straps do not cause irritation near the ears:
  • The ears must be free.
  • The straps must not rub above or below the eyes.
• Adjust the mask straps (if applicable) after the machine has started and the patient is comfortable in bed.
• Use your hands to check for air leakage around the mask. Adjust as needed.
• Pay particular attention to leakage around the eyes. This must be avoided, as it will cause red and sore eyes.
• Tighten the mask straps as little as possible - just enough to allow the mask to fit snugly. It should be possible to put two fingers under the straps after the mask has been tightened. It must be tightened the same on both sides, so the mask is not crooked on the face.
• If the mask has a double-layer cushion, it should be lifted slightly off the face to allow the space between the layers to fill with air after the machine has been turned on. This will form an air-cushion against the face, which counteracts air leakage and reduces the need to tighten the mask.

Skincare

• The user’s face must always be washed before putting the mask on. Avoid using skin creams.
• The user’s face might be marked after wearing the mask throughout the night, but marks should disappear quite quickly (30-60 minutes) after the mask has been removed.
• After removing the mask, wash the user’s face and preferably massage the skin with skin cream.
• If there are signs of soreness (redness and tenderness), request a change of mask.

Mask instructions

Written instructions for use are available for all types of masks. These are found in the package with the new mask. Always read them for excellent tips and advice on fitting and maintaining your mask!

Some manufacturers have also made films about the various masks on their website. The films show how one puts on the mask, tips and advice to avoid mask leakage and washing and maintenance of the mask. You'll find company name for the particular mask on the mask's packaging or by asking the healthcare professionals that helped you to customize the mask. It is also possible to find such films by searching the machine's name on YouTube.