Decision Guide for removing patients with suspected or ...
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Is the patient being treated for pulmonary TB?
No
Decision Guide for removing patients with suspected or confirmed tuberculosis from Airborne Precautions
Yes
Has the patient received
Yes
Are there 3 consecutive
Yes
at least 2 weeks of TB
negative AFB smears from
treatment?
separate days?
No
No
Do NOT remove the patient from airborne precautions. Contact the Department of Infection Control & Prevention with questions
Contact the Department of Infection Control & Prevention
to discuss removal from airborne precautions
Are there 3 negative AFB
smears collected at least 8
No
hours apart?
Yes
Is the patient at high-risk
for TB? See Box A for
Yes
examples
No
No
Contact the Department of
Is there at least 1 negative AFB
Is there at least 1
Infection Control & Prevention to discuss removal from
Yes
smear collected from a directed No
BAL or induced sputum?
negative non-induced sputum AFB smear?
Yes
airborne precautions
Yes
Has an alternate diagnosis been ESTABLISHED?
The decision to remove a patient from airborne precautions must consider the risk of possible disease transmission to other patients as well as healthcare workers. The decision should be careful and well- reasoned. This guide is designed to assist clinicians in determining if a patient may be eligible for removal from airborne precautions in patients with suspected or confirmed pulmonary tuberculosis. It is not intended to replace sound clinical judgment. Many patients have specific issues that make the use of this guide difficult. Such patients should be discussed with the Department of Infection Control and Prevention before a patient is removed from airborne precautions.
For questions or concerns call 936-0725
BOX A. High-risk conditions
1. Any HIV + patient 2. Cavitary upper lobe lung lesion 3. Cough 2 weeks with
Fever Abnormal CXR 4. Travel to/from a high-risk area 5. History of: Incarceration Homelessness 6. Use of immunosuppressants with the past 6 months (e.g. TNF- inhibitors, high-dose steroids)
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