2. All ICUs which utilize return air systems shall have the return air HEPA filtered.
Installation of ultraviolet (UV) lamps may be considered in ICUs in which there is a high risk for TB
transmission. All ICU rooms housing S/KI TB patients must, at a minimum7 meet the current CDC
guidance for S/KI TB.
F. Post Anesthesia Recovery Units (PARUs)
Medical Centers should have at least one recovery room within the PARU meeting at a minimum CDC
ventilation criteria for S/KI TB. As an option, especially in low-incidence areas, Medical Centers may
recover surgical patients with S/KI TB in an ICU isolation suite or room that meets CDC guidance for
S/KI TB
G. Surgical Suite (See MMWR October 28, 1994, Vol. 43, No. RR-13, p. 50-51 for details)
1. Existing VHA facility criteria (see HVAC Design Manual) and standards for surgery
are appropriate for surgical care of S/KI TB patients. Current VHA criteria exceed the CDC
guidelines. Typically, no changes will be required unless return air is used in the OR. VA criteria have
not sanctioned the use of return air in ORs for many years.
2. Traffic patterns should be designed to reduce unnecessary movement throughout the
surgical suite, hallways and other associated areas when surgery on a patient with S/KI TB is
performed.
3. Appropriate scheduling and other controls are necessary for surgery on S/KI TB
patients since positive pressure airflow is used in operating rooms.
H. Long Term Care
In general, no rooms are required for S/KI TB patients as they should be transferred to an appropriate
MS&N nursing unit for diagnosis and treatment as needed until they are no longer infectious.
I. Ambulatory Care
1. Determining the Number of TB Rooms:
Deterrnining the number of TB rooms in the Ambulatory Care setting should be in alignment with the
facility risk assessment. Specifically, facilities in the lowest risk assessment category may not need rooms
with specific tuberculosis engineering controls at all, but rather a written plan for dealing with the possible
event of a S/KI TB patient reaching the facility. For facilities above the minimal risk category, the
following is a suggested method for determining the number of exarn/treatment or special treatment
rooms designated for S/KI TB patients in unscheduled ambulatory care areas (hospital-based, satellite,
and independent OPCs):
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