What isolation and precautions should be used when a patient is suspected of having TB?

• A. Place in an AIIR with negative pressure, staff wear fit-tested NIOSH respirator, patient wears surgical mask.
• B. Isolation in a standard room, staff wear surgical masks, patient no mask.
• C. Droplet precautions only, staff wear surgical masks, patient wears mask.
• D. No isolation; standard precautions.

Answer: (A)

TB is transmitted through airborne droplet nuclei, so preventing spread requires airborne precautions. The patient should be placed in an airborne infection isolation room with negative pressure so that air flows into the room and contaminated air does not escape to surrounding areas. Healthcare staff must use a fit-tested NIOSH-approved respirator (such as an N95) when entering the room to protect against inhaling the small particles that carry TB. If the patient must be moved or leave the room, they should wear a surgical mask to reduce the release of organisms into the environment. Standard or droplet precautions, or no isolation, do not provide adequate protection for TB, which is why the outlined airborne precautions are necessary.