Conflicting opinion

[Ruadh]

Need some advice on PPD reading. I've placed 100's of PPD's in LTC with most having been negative---some with minimal redness, but rarely induration.

Fast forward to my new job in a public health clinic. I'm working with my supervisor who has many years experience in Behavioral Health, although little in the way of clinic nursing. We have numerous PPD testing w/subsequent interpretations nearly everyday.

So, here's my dilemma: she claimed a 'read' as positive today and sent the patient for an x-ray. I disagreed. There was NO induration, only redness. The supervisor pressed on patient's arm and could "feel a palpable bump" and proceeded to grasp & measure this area. I felt the patient's arm too. I believe my co-worker was really "reaching" by categorizing this as a positive result. Again, the site was completely flat with zero induration.

I know what a positive looks like & this was NOT.....am I missing something obvious here? What do you all think out there? I researched on-line & in texts & found only the same documentation: INDURATION is what indicates +.

[canoehead, BSN, RN]

From your description, I agree with you. With any luck, she will realize she needs to refresh herself and the problem is solved. You could print out a good article, and tell her that you realized you needed to make sure you knew what you were talking about, and you found this fantastic information, would she like to take a look at it? Since she is your supervisor, I'd hesitate to do more. Maybe this will only come up every few years? One can hope.

[Ruadh]

Thank you for that great suggestion, 'Canoehead'. It is a little awkward for sure, although we gotta' do what's right now don't we? Currently, there is no other RN on the floor so at the time, I couldn't ask another colleague AND I didn't want to contradict her in front of the patient.

I plan to show her what I looked up in a nursing text and I have a great on-line site with some good visuals.....

Wish me luck! ;o/

[AceOfHearts<3]

I was always taught erythema does not equal a positive. I had a red mark from one for several weeks- I think from a preservative in it (got it done at a minute clinic due to a time crunch- I'll never do that again since they charge a ridiculous amount).