Question

You are an RRT working at a community hospital and receive and order to obtain a sputum sample on a patient suspected of having tuberculosis (TB). This patient is definitively diagnosed with TB and started on antibiotic therapy. Two days later he requires oxygen by nasal cannula at 2 L/min to maintain a SPO2 of > 94%, and continues to cough frequently raising bloody secretions. His physician orders a CT scan of his chest and abdomen due to sudden abdominal pain of unknown origin. You are called to assist in his transport down to the radiography.

Answer these questions fully related to this scenario:

1. What is the route of infectious disease transmission for tuberculosis?

2. What specific precautions, above standard precautions, will you follow while you obtain the sputum sample?

3. What precautions above standard precautions will you follow?

Answer 1

Introduction :

Tuberculosis is carried by airborne particles which called droplet nuclei which mostly affects Lungs and causes by Mycobacterium Tuberculosis also called Tubercle bacilli.

Q1 - Below is the route of infectious disease transmission for tuberculosis :

The person who have pulmonary or laryngeal TB disease generates infectious droplet nuclei. And this spreads when patients cough or sneeze. These droplet nuclei remains in the air for some hours. When a healthy person inhales the infected air, that person also becomes infected. How much person will infect ( Mild or severe) is also depends on what number of tubercle bacilli the infected person expels. The more tubercle bacilli present in the air, the probability is more that infection will be transmitt. Infection risk also depends on exposure to the patient. Less duration exposure risk will be less and more duration exposure risk will be more. These inhaled infectious particles go through nasal passages then upper respiratory tract then bronchi and then reach to alveoli of lungs.  

Q2 - Below are the specific precautions while obtaining sputum sample:

*As standard precautions before doing collection, you should worn personal protective equipments like gloves, footwear, face mask, goggles.

*Other than this, the collected sample should be packed with triple packaging system . This packing will prevent infection during transportation of sample.

*Patient should be in isolated room with air exhausted to the outside of the building without recirculation.

*Avoid more exposure duration.

Q3 - Precautions above standard precautions to follow :

* isolated rooms should provide negative pressure with minimum 6 air exchanges per hour. *Patient should be with face mask.

*While trasporting the patient avoid reception or areas with other people.

*No material should be placed in the mouth to prevent infection.