2. Facility/air:
a. Meet at a minimum current CDC guidelines for unscheduled areas and high risk
clinics.
b. Meet a minim m current CDC guidelines for ventilation and airflow for S/KI TB:
u
(1)
Emergency area Isolation room(s) (anteroom not required)
(2)
ENT room(s)
(3)
Aerosolized pentamidine room(s)
(4)
Designated exam/treatment/procedure room(s)
3. Unscheduled areas
All unscheduled ambulatory care areas and associated waiting- areas should have ventilation designed
and maintained to reduce the risk of tuberculosis transmission. Germicidal UV lamps and/or HEPA
filters may provide additional benefit when used to supplement ventilation, particularly in facilities
located in areas of high incidence for TB.
4. Scheduled areas (clinics)
All scheduled areas serving patients who are at high risk for TB transmission should be designed to
reduce the risk of TB transmission. Air from clinics serving patients at high risk for TB should not be re-
circulated unless it is first passed through an effective high-efficiency filtration system (HEPA filters are
currently the effective high-efficiency filtration system available).
5. Designated exam/treatment rooms for S/KI TB
VHA ambulatory care programs in Medical Centers and in satellite/independent outpatient clinic must
have some facilities that are adequate to deal with S/KI TB patients. These TB rooms can be
exam/treatment rooms and/or special procedures rooms that are designated for use with S/KI TB patients.
These rooms should meet CDC guidance for S/KI TB with the additional requirement that a minimum of
12 air changes per hour must be exhausted (See IV.A.2). These rooms would normally be located 'm or
near the walk-in clinic module.
J. High Risk Areas
1. Potential Aerosol Producing Procedure Areas:
a. The pulmonary function laboratory (including spirometry and exercise rooms),
bronchoscopy area(s), pulmonary function treatment rooms, and sputum induction areas and any other
special procedure room (e.g., ENT) in which cough inducing procedures are done on patients who may
have infectious TB must meet CDC guidelines for S/KI TB with the additional requirement that a
minimum of 12 air changes per hour must be exhausted. Additionally, airflow rates should be calculated
on expected patient turnover in these treatment areas based on the most recent CDC guidance.
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