Tuberculosis is a disease that implies an occupational risk for health personnel who care for this type of patient. Due to the Mycobacterium tuberculosis agent being eliminated from the infected patient to the environment through different actions, including coughing and sneezing, the act of spitting, singing, or even conversation causes these risks.
The tiny droplets evaporate quickly and become aerosols of small particles that, due to their size (1-3 µm), remain in suspension and can be transported, depending on the airflow, through the room or a building. The small size facilitates its arrival in the pulmonary alveoli. The risk of transmission is confined to people who share closed and poorly ventilated places due to the high concentration of aerosols in that space.
Specific airborne isolation precautions for tuberculosis include the use of an N95 mask; it is used to protect workers, patients, family members, and visitors. This article seeks to explain and disseminate the procedure for using the N95 mask or respirator to standardize its use and achieve its protective function.
Risk of the infection
In general, young children with pulmonary tuberculosis are less likely than adults to be infectious. Because infants are sometimes unable to cough up sputum or may have paucibacillary tuberculosis; however, they can transmit M. tuberculosis if their bacilloscopy is positive or if they have a cavitation radiograph.
Every patient with pulmonary tuberculosis has a potential risk of spreading the infection, so using an N95 mask while in contact with the patient is a protective measure that must be followed at all times.
The application of standard precautions is determined according to the identification of risks of the procedures to prevent the exposure of health workers, patients, and relatives to potential infections. However, specific isolation precautions are used when a patient identifies an infection or probable infection.
Precautions for Tuberculosis
The use of specific airway isolation precautions for tuberculosis patients must precede medical care activities and are barriers that prevent the transmission of pathogens. They are listed below:
- Hand hygiene;
- Personal protective equipment: gloves, gown, mask, glasses, or goggles;
- Use of N95 mask before entering the patient’s room;
- Single room, keep the door closed;
- Ideally, negative pressure rooms;
- The room air exchange must be a minimum of 12 times per hour.
The additional recommendations that should be used by health personnel (doctors and nurses) or the people who have the greatest contact with the patient with pulmonary tuberculosis include:
- Use non-sterile gloves when handling secretions.
- Transfer the patient as soon as possible; notify the corresponding service if necessary.
- Pre-place an N95 mask on the patient.
- Put on you and the personnel in charge of transporting or handling the patient the N95 mask.
- Schedule the patient to carry out studies either at the beginning or end of the shift, indicating cleaning the area after these.
- Use material and equipment exclusively for the patient and do not share it with other patients.
- Upon patient discharge, request exhaustive cleaning of the area and disinfection of the equipment used with the patient.
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