Question

Protection of OT personnel during surgery for tuberculosis.

Hint:

Stringent infection control measures, including the use of PPE, negative pressure rooms, and patient isolation, are essential to protect OT personnel during surgery for tuberculosis.

Answer 1

Protection of operating theatre (OT) personnel during surgery for tuberculosis (TB) is essential to prevent the transmission of the disease, as TB is primarily spread through airborne droplets. Strict infection control measures are required to protect healthcare workers and minimize the risk of nosocomial transmission.
Step 1: Use of Personal Protective Equipment (PPE):
- N95 Respirators: All OT personnel must wear N95 respirators, which are designed to filter out airborne particles, including Mycobacterium tuberculosis. These should be worn by everyone in the operating room, including surgeons, nurses, and anesthetists.
- Protective Clothing: Gowns, gloves, and eye protection should be worn to minimize the risk of contact with contaminated surfaces. Surgical drapes and face shields are also recommended during procedures that may produce aerosolized particles.
Step 2: Airborne Infection Control:
- Negative Pressure Rooms: The operating room should be a negative pressure room to ensure that contaminated air is expelled from the room and does not circulate to other areas of the hospital.
- Proper Ventilation: The operating room should have adequate ventilation with a high turnover of fresh air to dilute and remove potentially contaminated air.
- Aerosolized Particles: During surgery, the creation of aerosolized particles (e.g., during intubation, suctioning, or cauterization) can increase the risk of transmission, so extra precautions should be taken.
Step 3: Patient Isolation:
- Preoperative Screening: TB screening should be performed on all patients before surgery. If the patient has active TB, the surgery should be delayed until they are no longer infectious, if possible.
- Isolation: Patients with active pulmonary TB should be isolated in a well-ventilated room before and after surgery to prevent the spread of airborne particles. The use of a surgical mask for the patient is essential to prevent contamination.
Step 4: Postoperative Measures:
- Environmental Cleaning: After surgery, the operating room should undergo thorough cleaning with appropriate disinfectants to eliminate any residual bacterial contamination.
- Monitoring of Healthcare Workers: OT personnel should be regularly monitored for symptoms of TB, and any potential exposure should be followed by appropriate testing, including a tuberculin skin test (TST) or interferon-gamma release assay (IGRA).