Flashcards in BUMEDINST 6224.8B Deck (30)
What is the purpose of the TB Control Program?
To provide policy and guidance for controlling tuberculosis (TB) among
Department of the Navy (DON) military personnel and Military Sealift Command (MSC)
civilian mariners (CIVMAR).
Name the forms used for medical recording of TB patients.
For medical record and information gathering purposes we provide NAVMED
6224/7, Initial Tuberculosis Exposure Risk Assessment, NAVMED 6224/8, Interim Tuberculosis
Exposure Risk Assessment, and NAVMED 6224/9, Monthly Evaluation for Patients Receiving
Treatment for Latent Tuberculosis Infection.
What is the responsibility of the MTFs?
MTFs must continue the annual risk assessment as per CDC and Prevention guidelines or more frequent if there are changes in the TB control program or in the epidemiology of TB.
What form is the NAVMED 6224/7 (08-2008)?
Initial Tuberculosis Exposure Risk Assessment
What form is the NAVMED 6224/8 (Rev. 03-2011)?
Tuberculosis Exposure Risk Assessment
What form is the NAVMED 6224/9 (08-2008)?
Monthly Eval for Patients Receiving Treatment for Latent TB Infections (LTBI).
What form is used for the Adult Immunizations Record?
NAVMED 6230/4 (Rev. 10-2007)
When should service members begin testing for TB?
TB testing should be started on entry into naval service.
Fact of TB?
Personnel diagnosed with Latent TB Infection (LTBI) based on positive skin or blood test and without active disease are not infectious.
Individuals with a history of TB, positive Tuberculosis Skin Test (TST), LTBI test or treatment for LTBI must provide what documentation?
Documentation of clinical evals, hospitalizations, diagnoses, and treatments. Copies of pertinent medical records, treatment records, or a physician's statement on letterhead stationery.
What steps should be taken if patient has pertinent medical information about their TB results?
Pertinent information should be transcribed into the medical record.
Screening After Receipt of PCS orders to a Commissioned Vessel.
All personnel must be screened for LTBI during operational suitability screening. Screening or testing documented within 6 months prior to reporting aboard a commissioned vessel is acceptable.
LTBI Screening At Times Other Than Entry are:
During Periodic Health Assessment (PHA), and individuals answering "yes" to one or more question on the NAVMED 6224/8.
How often are Civilian Mariners screened or tested for TB?
CIVMARs will be screened or tested annually during their PHA.
T or F: It is no longer required that all personnel have LTBI test results documented within the 6 months prior to sep or retirement?
What is the approved TST material for the routine Mantoux test?
Tween-80-stabilized intermediate strength PPD (5TU equivalent)
What is the preferred product?
Tubersol from Sanofi Pasteur
If Tubersol is not available what is the next acceptable product.
What information is recorded on the NAVMED 6230/4 and AHLTA?
Date administered, type, strength of tuberculin, manufacturer, lot number, route of administration
What time frame must the TST be read within?
48 to 72 hours after PPD administration
Measure induration to nearest whole millimeter (mm).
If patient returns after 72 hrs after TST, record results as "Not Read" and apply on opposite forearm
If patient doesn't return at all, enter "Not Read", patient must be recalled and given another test.
TST test results can be entered into authorized electronic med information systems such as AHLTA, MRRS or SAMS.
If there is no induration, record results as "0 mm" or "zero mm"
Another test used if TST test is not available is the QuantifFERON-TB Gold (QFT-G)
QFT-G results must be recorded in detail. Date of blood draw, result in specific units, concentration of cytokine measured and lab interpretation (pos, neg, or indeterminate)
TSTs can be administered to persons who received Bacillus Calmette Guerin (BCG) immunization
A positive TST reaction in BCG immunized individuals should be regarded as indicative of TB infection.
False negative TST results can occur if administered within a short period after receiving parenteral live-attenuated virus vaccines.
A TST may be placed on the SAME DAY parenteral live-attenuated virus vaccines are given or at least 4 weeks later.
TST are both safe and reliable throughout pregnancy.
Persons with an increase in reaction sized of 10 mm or more, within a three-year period is considered positive.
LTBI treatment is as followed: isoniazid (INH) 5 mg/kg (300mg max) daily for 9 months to accomplish 270 daily doses within 12 months.
Routine lab monitoring is nessessary for those persons whose baseline liver function test are abnormal or at risk for liver disease.
Directly observed therapy (DOT) should be used for patients who are at very high risk for TB and high risk of non-adherence.
Patient education and counseling should be documented on the SF 600, "Medical Record Chronological Record of Medical Treatment"
Sugical masks does not provide complete protection from airborne infectious particles.