TUBERCULOSIS:

Environmental Controls
Early Identification

• Any patient suspected of having TB should be tested. The Mantoux Skin Test, also known as the purified protein derivative (PPD) test, is used as an initial check for the presence of TB infection. Next, chest radiographs and sputum smears will be completed to diagnose active TB.

• Patients with a persistent couch, who also complain of unexplained weight loss, fever or night sweats should be tested.

• Patients with only some TB-like symptoms, patients with a history of TB, patients belonging to a high-risk group, or patients who have had exposure to TB should be tested.

• Patients infected with TB should be given preventative medication.

• Patients with active TB should be placed in respiratory isolation

• You should receive the Mantoux skin test, or PPD, at the time of hire. This will serve as a baseline for later comparison.

• If you have previously tested positive, have had adequate treatment for the disease, or have previously recovered from TB, you are exempt from a skin test. You should still have a chest radiograph or sputum smear if symptoms develop.

• If you have an unprotected exposure, you should have a skin test done immediately.

• If you experience any symptoms of active TB, you should immediately report your symptoms and promptly be tested for active TB. You should monitor your own heath as carefully as you monitor your patients.
  

Work Restrictions
If you are diagnosed with pulmonary or laryngeal TB, you should be restricted from work until

• You get treatment

• Your cough is resolved

• A physician certifies that you are no longer contagious

If you have the TB infection, but not active TB, you should take preventative medication and continue usual work activities.

If you are looking for more information on tuberculosis, call Coastal Health Train at 1-800-729-4325 and ask about receiving a free hand-book.

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Helpful Hints:
Causes of Ear Pain at a Glance

Serious Otitis Media.
Usually painless, however patient has a (fluid in the middle ear) feeling of "fullness", there may be a loss of hearing. The eardrum looks dull (white or yellowish) with a scattered light reflection. No fever. May lead to a true middle ear infection but is not usually treated with antibiotics.

Acute Otitis Media.
The classic, painful middle ear infection, ear pain may be intense, crying and irritability in infants, may be a fever, pulling or tugging on ear, loss of appetite, or even vomiting. Hearing is decreased temporarily. The eardrum will appear to be red and bulging in most cases.

Chronic Otitis Media.
Recurrent middle ear infection or those that fail to clear on antibiotics, feeling of fullness, possible pain, ear pulling, occasional fevers, ear drum may be red and dull appearing, decreased hearing.

Wax Impactions.
Usually painless, but may cause irritation and lead to a "swimmer's ear." Can cause dizziness if wax is impacted against eardrum. There is a hearing loss. Easy to see with otoscope. May be removed with a warm water wash if there is no pain, eardrum perforation or tubes. Difficult or large, dry plugs often require professional removal.

Pimples in the Ear.
Pimples can occur in the ear canal and can be painful. they can be seen with careful inspection of the ear canal with the otoscope. Do not squeeze or lance them. Should not be treated at home - can lead to a more serious, deeper infection. Usually requires antibiotics.

Dental Problems.
Cavities or dental infections can cause the lymph nodes to swell which causes ear pain. Look carefully at the teeth and look for redness or swelling of the gums. Cavities may not be obvious. See your dentist. Teething rarely results in ear pain.

Lymph Node Infections.
Tender, enlarged lymph nodes in the neck can cause referred ear pain. Lymph node infections can originate from a variety of infections in the head, neck or face. Feel the neck carefully for tender or enlarged lymph nodes. May need antibiotics.

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Growth Disorders
Healthy Breakfast

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