1. sss Employee Health sss

2. RESPIRATORY PROTECTION for TUBERCULOSIS
a Health Care Worker
GUIDE for RESPIRATORY PROTECTION

3. Tuberculosis is a contagious bacterial disease
Tuberculosis is a contagious bacterial disease. Tuberculosis is spread by the respiratory route: TB bacteria contaminate droplets that get into the air when a patient with the disease speaks, coughs, or sneezes A person breathes in these droplets from the air If you inhale the Tuberculosis bacteria, you may get infected but not get sick with TB disease A tuberculosis infection can be detected with a PPD (tuberculosis skin test) Tuberculosis disease is potentially severe and usually affects the lungs but may affect other organs.
HCW = Healthcare Worker

4. SYMPTOMS OF TUBERCULOSIS chronic cough unexplained weight loss fever night sweats coughing up blood
What is the difference between TUBERCULOSIS INFECTION and TUBERCULOSIS DISEASE?
INFECTED No DISEASE
INFECTED DISEASE
NOT INFECTED

5. NO RESPIRATOR REQUIRED
NOT
INFECTED
PPD NEGATIVE
PPD
Chest X-RAY NEGATIVE
NO RESPIRATOR REQUIRED
X-RAY
N95
NOT
CONTAGIOUS
HEALTHCARE
WORKER
PATIENT

6. NO RESPIRATOR REQUIRED
INFECTEDNO DISEASE
PPD POSITIVE
PPD
Chest X-RAY NEGATIVE
NO RESPIRATOR REQUIRED
X-RAY
N95
NOT
CONTAGIOUS
HEALTHCARE
WORKER
PATIENT

7. INFECTED+ DISEASE PPD POSITIVE Chest X-RAY POSITIVE
RESPIRATOR REQUIRED
X-RAY
N95
HEALTHCARE
WORKER
CONTAGIOUS

8. in preventing the spread of TB is to quickly identify isolate and
The FIRST STEP
in preventing the spread of TB
is to quickly identify
isolate and
treat contagious patients
PREVENTION MEASURES
TB patients are put in rooms with special ventilation systems
BUT
When you are in close contact with a contagious TB patient
RESPIRATORS ARE NECESSARY
TO PROTECT YOU

9. RESPIRATOR DEFINITION
Respirators are protective equipment that are designed to protect the wearer against harmful airborne agents. A seal is formed between face and the respirator.
A surgical mask is not a respirator
Because the surgical mask does not fit tightly to the face it does not provide good protection against airborne hazards.
REQUIREMENTS
Wearing a respirator reduces your chances of becoming
infected with TB. The Hospital Infection Control committee
determines when a healthcare worker must wear a
respirator. The Occupational Safety and Health
Administration (OSHA) regulates the use of
respirators. NIOSH approves respirators for use.

10. RESPIRATORS MUST BE USED CORRECTLY
Respirator Types
-Air purifying respirators filter out harmful agents from the air Air supplying respirators supply clean air to the person for breathing
Healthcare workers wear AIR PURIFYING respirators to protect against TB. OSHA requires the use of certified respirators when respiratory protection is needed. The National Institute for Occupational Safety and Health (NIOSH) gives each certified respirator and certification number which is usually present on the respirator or attached on an instruction sheet.
AS WITH ALL PERSONAL PROTECTION EQUIPMENT
RESPIRATORS MUST BE USED CORRECTLY
TO PROVIDE THE HEALTHCARE WORKER WITH THE BEST PROTECTION
TRAINING AND EDUCATION ARE KEY FOR YOUR PROTECTION

11. Respirator Training Topics to cover Procedures for selecting
respirators
Medical
Evaluations
for
respirator
users
Fit
Testing
Procedures
for
respirator
users
Procedures
for
Proper
use of
respirators
Procedures
for
Cleaning
Storing
Inspecting
Discarding
Respirators
Topics to cover
ISOLATION
SIGNS
for
AIRBORNE
PRECAUTION
RESOURCES

12. Procedures
for
selecting
respirators
Respirator Training
N The respirator to use when respiratory protection for Tuberculosis is needed.
N95
HEALTHCARE
WORKER

13. Employee Health will provide a medical evaluation
Evaluations
for
respirator
users
Respirator Training
Employee Health will provide a medical evaluation
to determine the HCW ability to use a respirator.
This is done before the employee is fit tested or
is required to use the respirator.
Using a respirator may place a physiological burden on the HCW that varies with the type of respirator worn, job conditions, and medical status of the HCW.
A licensed health care professional will perform the evaluation using a medical questionnaire. The contents of the medical questionnaire are mandated by OSHA. This questionnaire is administered to the HCW in a confidential manner and the HCW can request to discuss the results of the medical evaluation with the licensed health care professional. EMPLOYEE HEALTH will provide the HCW with a WRITTEN STATEMENT regarding the outcome of the MEDICAL EVALUATION.

14. FOLLOW UP MEDICAL EVALUATIONS are performed:
respirator
users
Respirator Training
FOLLOW UP MEDICAL EVALUATIONS are performed:
1- if HCW reports medical signs or symptoms that are related to ability to use the respirator.
2- if the supervisor informs Employee Health of the need for re-evaluation
3- if information from the respirator program monitoring activities indicates a need for re-evaluation
4- if the workplace conditions significantly change

15. FIT TEST procedure is done:
Testing
Procedures
for
respirator
users
Respirator Training
FIT TEST procedure is done:
1- before initial use of the respirator
2- whenever a different size, style, model or make of respirator is used
3- if HCW has a change in facial structure such as: facial trauma, facial surgery, loss of body weight, or dental changes.
4- if the HCW worker notifies the employer that the respirator fit is unacceptable.
5- at least annually

16. Fit
Testing
Procedures
for
respirator
users
Respirator Training
FIT TESTING is done using an OSHA accepted qualitative fit test procedure.
HEALTHCARE WORKER puts on the RESPIRATOR -- a HOOD is applied over the head of the HCW -- sweet tasting aerosol mist is introduced into the hood -- if the seal is tight the HCW should not experience any sweet taste.
The test simulates activities such as turning the head, talking, and other possible activities that might occur during job tasks.
N95

17. DIRECTIONS FOR PUTTING ON THE RESPIRATOR
Procedures
for
Proper
use of
respirators
Respirator Training
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
N95
1. Separate the mask to fully open
2. Gently bend the nose piece to conform the mask to face
3. Hold mask upside down to expose the two head bands
4. Separate the head bands with the index fingers
5. Cup the mask under chin - ORANGE side out
6. Bring the head bands over the head
7. Place first head band at neck - pull the second head band
up and place at crown of head
8. Form nose piece across bridge of nose for tight fit

18. DIRECTIONS FOR PUTTING ON THE RESPIRATOR
Procedures
for
Proper
use of
respirators
Respirator Training
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
N95
1. Separate the mask to fully open

19. DIRECTIONS FOR PUTTING ON THE RESPIRATOR
Procedures
for
Proper
use of
respirators
Respirator Training
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
N95
2. Gently bend the nose piece to conform the mask to face

20. DIRECTIONS FOR PUTTING ON THE RESPIRATOR
Procedures
for
Proper
use of
respirators
Respirator Training
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
N95
3. Hold mask upside down to expose the two head bands

21. DIRECTIONS FOR PUTTING ON THE RESPIRATOR
Procedures
for
Proper
use of
respirators
Respirator Training
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
N95
4. Separate the head bands with the index fingers

22. DIRECTIONS FOR PUTTING ON THE RESPIRATOR
Procedures
for
Proper
use of
respirators
Respirator Training
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
N95
5. Cup the mask under chin - ORANGE side out

23. DIRECTIONS FOR PUTTING ON THE RESPIRATOR
Procedures
for
Proper
use of
respirators
Respirator Training
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
N95
6. Bring the head bands over the head

24. DIRECTIONS FOR PUTTING ON THE RESPIRATOR
Procedures
for
Proper
use of
respirators
Respirator Training
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
N95
7. Place first head band at neck - pull the second head band
up and place at crown of head

25. 8 Respirator Training DIRECTIONS FOR PUTTING ON THE RESPIRATOR
Procedures
for
Proper
use of
respirators
Respirator Training
DIRECTIONS FOR PUTTING ON THE RESPIRATOR
N95
8. Form nose piece across bridge of nose for tight fit 8

26. DIRECTIONS FOR USING THE RESPIRATOR
Procedures
for
Proper
use of
respirators
Respirator Training
DIRECTIONS FOR USING THE RESPIRATOR
Each time the HCW enters the contaminated area,
face seal should be checked to make sure the fit
is tight.
Adjust the nosepiece if there is air leakage around
the nose.
Reposition head bands to secure facial seal around
the edges of respirator.
N95
IT IS THE HEALTHCARE WORKER’S RESPONSIBILITY TO OBTAIN A PROPER FIT EACH AND EVERY TIME.
IF YOU DO NOT OBTAIN A PROPER FIT,
DO NOT ENTER THE ISOLATION AREA.

27. DIRECTIONS FOR USING THE RESPIRATOR
Procedures
for
Proper
use of
respirators
Respirator Training
DIRECTIONS FOR USING THE RESPIRATOR
HEALTHCARE
WORKER
N95
Facial hair will make the seal loose
and will not provide protection
from harmful airborne hazards
Even one or two days beard growth
can effect the seal.
Male HCWs should be clean shaven
This to ensure that the respirator is fully protective.

28. Respirator Training Procedures for Cleaning Storing Inspecting
Discarding
Respirators
Respirator Training

29. ISOLATION Respirator Training
SIGN
for
AIRBORNE
PRECAUTION
Respirator Training
An ISOLATION SIGN as this one will appear on the entrance to the patient room. Instructions for personal protective equipment are listed on the card. TAKE NOTE and FOLLOW THE INSTRUCTIONS
STOP
STOP
ISOLATION
PLEASE READ PRECAUTIONS BEFORE ENTERING
PRECAUTIONS GLOVES GOWNS MASKS TRANSPORT ROOM
AIRBORNE YES NO YES XXXX PRIVATE
CONTACT YES YES NO XXXX PRIVATE
DROPLET YES NO YES XXXX PRIVATE

30. PROGRAM ADMINISTRATOR -- Iva Jones, RN CIC
RESOURCES
PROGRAM ADMINISTRATOR -- Iva Jones, RN CIC
INFECTION CONTROL
American Lung Association
St. Louis City Health Department
St. Louis County Health Department

31. sss Employee Health sss