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How long are airborne precautions to be in place with TB?

Posted

I had a patient with a HISTORY of TB, or so the person who gave report told me. I didn't actually see it anywhere, but anyways. I just put a mask on in case, but someone said it's not contagious now. Whats the policy where you work on isolation precautions when people have had TB? I always thought if they'd had it before then we're supposed to wear a mask.

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 10 years experience.

I had a patient with a HISTORY of TB, or so the person who gave report told me. I didn't actually see it anywhere, but anyways. I just put a mask on in case, but someone said it's not contagious now. Whats the policy where you work on isolation precautions when people have had TB? I always thought if they'd had it before then we're supposed to wear a mask.

History of successfully treated TB does not require isolation precautions. You thought wrong. The history is relevant to care in that they may have scarring in the lungs and may require more aggressive therapy for a respiratory illness or distress

Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 15 years experience.

You should also know your facility's policy for isolation- all types. This will help you understand who should be in isolation, when, and how subsequent admissions are handled.

Thanks guys. I actually thought I knew the policy until I saw one person wear a mask and another not. One time I had a similar patient and got yelled at for not wearing one. I'm starting to see that where I work people kind of follow their own policy which of course is not good. I'm planning on going somewhere else, but can't right now. Anyways, I've looked it up and agree it's not necessary, but what if the person had it and we didn't know? We weren't testing for it. I guess I just thought I'd be safe in case.

sourapril

Specializes in public health. Has 5 years experience.

CDC is the best place to check if you don't know what precaution to take.

In general, patients who have suspected or confirmed TB disease should be considered infectious if:

  1. They are coughing, undergoing cough-inducing procedures, or have positive sputum smear results for acid-fast bacilli (AFB); and
  2. They are not receiving adequate antituberculosis therapy, have just started therapy, or have a poor clinical or bacteriologic response to therapy.

For patients placed under airborne precautions because of suspected infectious TB disease of the lungs, airway, or larynx, airborne precautions can be discontinued when infectious TB disease is considered unlikely and either:

  • Another diagnosis is made that explains the clinical syndrome; or
  • The patient produces three consecutive negative sputum smears collected in 8 to 24-hour intervals (one should be an early morning specimen).

Patients for whom the suspicion of infectious TB disease remains after the collection of three negative sputum smear results should not be released from airborne precautions until they:

  • Receive standard multidrug antituberculosis treatment (minimum of 2 weeks); and
  • Demonstrate clinical improvement.

For these patients, additional diagnostic approaches (e.g., sputum induction) and, after sufficient time on treatment, bronchoscopy may need to be considered.

Patients who have drug-susceptible TB of the lung, airway, or larynx, should remain under airborne precautions until they:

  • Produce three consecutive negative sputum smears collected in 8 to 24-hour intervals (one should be an early morning specimen)
  • Receive standard multidrug antituberculosis treatment (minimum of 2 weeks); and
  • Demonstrate clinical improvement.