About Mantoux Shots: Correct me if I'm wrong

medicrnohio, RN · Jan 22, 2005

Every facility is different. Some may require a yearly chest x-ray and others may require the checklist. It would be useless to get a Mantoux done after having a positive. You will always have a positive.

RNPATL, DNP, RN · Jan 22, 2005

My understanding is if you have a positive reaction for any reason you take a chest x-ray. If the x-ray is negative then instead of getting a yearly shot you just fill out a symptom-check list and have it signed by a nurse. What would happen if kept getting a yearly shot anyways because you were told you had to.

Most employers need to be reminded annually that you test positive. Again, most employers will not require you to have a mantoux test if you test positive. You will continue to have a reaction each year, if you have the test.

BittyBabyGrower, MSN, RN · Jan 22, 2005

Where I work, you have a yearly chest film if you are positive tester.

donmomofnine · Jan 22, 2005

The first time you test positive, at our facility, we ask for an xray. Every year after that, you just do the checklist. If you come to us having been positive in the past, we ask for a copy of the xray report and do checklists from then on.

GLORIAmunchkin72 · Jan 22, 2005

My problem was not with my facility. It was with a local doc who insisted that I have another shot or he wouldn't sign my papers to start class. He is from the same clinic where I had my NEGATIVE chest x-ray. He also made me sign a paper relieving him of liability. The result was the reaction just got bigger

The first time you test positive, at our facility, we ask for an xray. Every year after that, you just do the checklist. If you come to us having been positive in the past, we ask for a copy of the xray report and do checklists from then on.

stbernardclub · Jan 22, 2005

yup....ditto ....

The first time you test positive, at our facility, we ask for an xray. Every year after that, you just do the checklist. If you come to us having been positive in the past, we ask for a copy of the xray report and do checklists from then on.

chris_at_lucas_RN, RN · Jan 22, 2005

My problem was not with my facility. It was with a local doc who insisted that I have another shot or he wouldn't sign my papers to start class. He is from the same clinic where I had my NEGATIVE chest x-ray. He also made me sign a paper relieving him of liability. The result was the reaction just got bigger

check with the CDC. I've just spent about half an hour looking for a page on their site that I found last year, in an attempt to keep from having a second Mantoux (which, btw, is a "test," not a "shot").

The risk is this. The Mantoux will always be positive on a person for whom it has ever been positive because it indicates whether there are antibodies present. If the antibodies are present, they always will be, and you will always be postive. Therefore, to continue to do Mantoux on you is to continue to expose you to mycobacterium unnecessarily. (Not good care.)

If you are continually exposed to mycobacterium, there is a small risk that you will develop an infection. That was the tidbit I was looking for.

You might call the CDC and see if you can get something specific from them.

And then you might change docs. You need one who knows what he is doing. No offense meant. Just advocating for the good care of you.

Good luck.

GLORIAmunchkin72 · Jan 22, 2005

Thanks everyone!

check with the CDC. I've just spent about half an hour looking for a page on their site that I found last year, in an attempt to keep from having a second Mantoux (which, btw, is a "test," not a "shot").
The risk is this. The Mantoux will always be positive on a person for whom it has ever been positive because it indicates whether there are antibodies present. If the antibodies are present, they always will be, and you will always be postive. Therefore, to continue to do Mantoux on you is to continue to expose you to mycobacterium unnecessarily. (Not good care.)
If you are continually exposed to mycobacterium, there is a small risk that you will develop an infection. That was the tidbit I was looking for.
You might call the CDC and see if you can get something specific from them.
And then you might change docs. You need one who knows what he is doing. No offense meant. Just advocating for the good care of you.
Good luck.

Gail-Anne · Jan 22, 2005

How about you are right and wrong?!!! "Positive" or "negative" on a Mantoux is a bit confusing, we never use it.. A person who is very immunesuppressed can read "0" and have active TB. A reading of 5mm can be indicative on HIV person for example, but no big deal for most of us. A reading over 10mm for most of us means investigate further. We sometimes do double-tests depending on other factors.

For staff, the big issue is whether or not there is a change in the reading after exposures to TB. Our facility will ask for retesting for all exposed staff. I react to the test itself (sensitivity) now, so for me that can mean chest X-ray a few weeks after exposure. (So I don't have Mantoux- only give them and read them)

Hopefully that makes sense! Also, for us old nurses who had to have BCG's in training, that only gives a reaction for about 20 years, if you are reacting after that, it's from an exposure. Lucky that exposure rarely leads to anything for healthy people.

GLORIAmunchkin72 · Jan 22, 2005

This doc never gave a rationale for retesting. When my teacher (an RN) found out about it she had a fit. She told me that I should have never caved in and should have taken steps to openly challenge this doctor. I really wasn't in the mood for all that. After all I didn't die. But I am not willing to do that again.

How about you are right and wrong?!!! "Positive" or "negative" on a Mantoux is a bit confusing, we never use it.. A person who is very immunesuppressed can read "0" and have active TB. A reading of 5mm can be indicative on HIV person for example, but no big deal for most of us. A reading over 10mm for most of us means investigate further. We sometimes do double-tests depending on other factors.
For staff, the big issue is whether or not there is a change in the reading after exposures to TB. Our facility will ask for retesting for all exposed staff. I react to the test itself (sensitivity) now, so for me that can mean chest X-ray a few weeks after exposure. (So I don't have Mantoux- only give them and read them)
Hopefully that makes sense! Also, for us old nurses who had to have BCG's in training, that only gives a reaction for about 20 years, if you are reacting after that, it's from an exposure. Lucky that exposure rarely leads to anything for healthy people.

bobnurse · Jan 24, 2005

If you are positive you must have a cxr done and then have an annual questionaire.....This is all stated in your facility hospital policy and procedures hopefully...

You dont get it again due to the reaction which can cause cellular necrosis to the injection site. This can also get infected as well. NOt a good thing.