1. 1 SESSION 6: Field Safety and Infection Control

2. DOT Curriculum Session 62 Transmission of M. Tuberculosis 1. TB is transmitted through the air by a person with TB disease of the lungs or larynx 2. Droplets containing M. tb are released into the air by coughing, sneezing, talking, or breathing

3. DOT Curriculum Session 63 Transmission of M. Tuberculosis (2) 3. For TB transmission to occur, 3 things are required: a TB patienta TB patient an air pathan air path a susceptible persona susceptible person

4. DOT Curriculum Session 64 Transmission of M. Tuberculosis (3) 4.Characteristics of TB transmission include the following: a single TB droplet may be able to cause infectiona single TB droplet may be able to cause infection it is relatively difficult to become infected with TBit is relatively difficult to become infected with TB the source of TB infection may not be identifiedthe source of TB infection may not be identified

5. DOT Curriculum Session 65 Transmission of M. Tuberculosis (4) The chances of TB transmission occurring depend on three factors: 1. Source patient 2. Exposure time 3. Environment

6. DOT Curriculum Session 66 Work Practice Controls When transporting patients: 1. Provide and instruct the patient to wear a surgical mask over his/her mouth and nose. The patient should not wear a respirator 2. Have enough surgical masks available for the entire journey. Have patient change masks when wet or torn

7. DOT Curriculum Session 67 Work Practice Controls (2) When transporting patients: 3.Let the facility or department where you are going know in advance that the patient is arriving. Advise the facility or department in advance of the appropriate precautions and treatment needs of the patient

8. DOT Curriculum Session 68 Work Practice Controls (3) When transporting patients: 4. Wear an N-95 respirator during the entire journey 5. Drive additional passengers and staff members in a separate vehicle 6. Set ventilation controls to the fresh air or vent setting, rather than the recirculation setting

9. DOT Curriculum Session 69 Work Practice Controls (4) When transporting patients: 7. Set any fan(s) to a high setting 8. Open as many windows as possible 9. Leave the vehicle unoccupied with the windows open for at least an hour after the end of the journey

10. DOT Curriculum Session 610 Work Practice Controls (5) When working in institutions at high risk for TB transmission: 1. Conduct as much work as possible in non-patient/resident care areas 2. Keep doors and windows open as much as possible

11. DOT Curriculum Session 611 Work Practice Controls (6) When working in institutions at high risk for TB transmission: 3. Give several tissues to a potentially infectious person and instruct him/her to cover his/her nose and mouth when coughing or sneezing

12. DOT Curriculum Session 612 Work Practice Controls (7) When conducting home visits: 1. Explain the precautions taken to prevent transmission of TB and ask for patient’s cooperation 2. When appropriate, conduct the visit outdoors

13. DOT Curriculum Session 613 Work Practice Controls (8) When conducting home visits: 3.Give the patient several tissues and instruct him/her to cover his/her nose and mouth when coughing or sneezing 4.Open a window and sit near it if indoors

14. DOT Curriculum Session 614 Work Practice Controls (9) When conducting home visits: 5.Conduct the visit as efficiently as possible in order to reduce exposure time

15. DOT Curriculum Session 615 Work Practice Controls (10) When assisting a patient in the collection of sputum specimens in the field: 1.If possible, avoid being present during sputum induction or explain the precautions to be taken and ask for cooperation

16. DOT Curriculum Session 616 Work Practice Controls (11) When assisting a patient in the collection of sputum specimens in the field: 2.Take patient outside or to sputum induction room, if available 3.Wear a powered air–purifying respirator

17. DOT Curriculum Session 617 Review Questions 1.What are 5 ways to reduce personal safety hazards in the field? 2.What are 2 factors that affect the risk of M. tb transmission?

18. DOT Curriculum Session 618 Review Questions (2) 3.What are 3 ways TB control staff can protect themselves and others from exposure to active, infectious TB? 4.What are 3 requirements for using respirators (masks) properly?