Page updated 30 April 2007
Patient Procedures
Newly Diagnosed Open Pulmonary Tuberculosis Admitted to Hospital
- Admission to diagnose tuberculosis or institute treatment is rarely required. However, patients may be very ill and may even require intensive care, some are admitted for investigations of PUO and the diagnosis of tuberculosis becomes clear, and some are admitted because of reactions to antibiotics.
- "Source Isolate" patients in a side-room (preferably ventilated with a negative pressure in relation to the corridor) with the door shut for the first 14 days of therapy (See Source Isolation).
- If the room is not ventilated, leaving the window open when possible, ensures that any infectious droplets are diluted by outside air.
- A decision to discharge a patient home may be made during this initial treatment period.
After treatment has commenced, the number of infectious particles in the sputum will be very much reduced in most of the patients, who should no longer present a hazard to others. Patients who have a very high bacterial load in the sputum at the start of treatment or have multiply-resistant organisms may require isolation for longer, at the discretion of the medical staff and the Infection Control Team.
Source Isolation Procedures
- For patients with pulmonary tuberculosis, it is not necessary to wear a disposable plastic apron and gloves on entering the room.
- Aprons (yellow) and gloves should be worn when caring for patients with open discharging tuberculous lesions, or when performing bronchoscopy or tracheal suction.
- Special protective masks (see below) will be provided for staff entering the room of a patient known to have or suspected of having open tuberculosis. They should be worn when performing procedures likely to cause an aerosol. They must be worn by carers when it is known that a patient has drug-resistant tuberculosis.
- Wash your hands after dealing with the patient and when you leave the room.
- Wear disposable gloves when handling secretions (e.g. sputum pots).
- Disposable crockery and cutlery are not necessary.
- Clinical waste must be placed in yellow bags.
- Linen should be placed in a red alginate stitched bag and then a transparent plastic bag before being sent to the laundry.
- Patients may walk outside at the discretion of the nursing staff, but should not spend time in any general ward areas or indoor public areas.
- They should be dealt with quickly and not stay in shared patient areas for any longer than necessary. When visiting other departments in the hospital, it is not necessary for patients to wear masks.
- Discontinue these precautions when the patient comes out of isolation.
Tuberculosis at Other Sites
Isolation is not normally necessary. However, if there is an open lesion (e.g. a discharging sinus), isolate as above until 14 days of therapy have been given.
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