EMS: TB Testing and Guidelines

EMS (Emergency Medical Services) practitioners and emergency medical responders may be at an increased risk of TB (tuberculosis). We outline state requirements and guidelines that protect EMS workers.

TB test requirements for EMS

In Wisconsin, we recommend that people who do EMS work get a baseline TB test when they are hired. They should receive follow-up tests if they:

• Have TB symptoms, such as:
  • A cough that lasts for more than two months.
  • A cough with mucus or blood in the mucus.
  • Fever.
  • Night sweats.
  • Weight loss.
• Have been exposed to a person with known TB. It’s also helpful to think of possible exposures outside of EMS work, such as going on a medical mission to a place with high rates of TB.

For more information, view Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Settings, 2005. (PDF)

A positive TB test

A positive TB skin test or blood test doesn’t always mean you have TB. You likely have TB if you also have TB symptoms with a cough and/or mucus.

If you test positive for TB but don’t have symptoms, you may keep working with EMS until you complete the medical evaluation and chest radiography. These methods confirm if you have TB infection or TB disease:

• TB infection means that you can take preventive medicine. The medicine decreases the chance that the TB infection will become TB disease. People with TB infection can’t spread TB to others.
• TB disease means you can spread TB to others.

How to prevent TB exposure

It’s important to protect people who do EMS work from those who have TB disease. TB is spread through respiratory droplets that you can breathe in when you’re physically close to someone with TB. If you do EMS work, you must:

• Use standard respiratory care protocols.
• Use a surgical mask, when possible, to cover a person’s active cough.
• Wear N-95 respirators to prevent breathing in TB droplets.
• Use the ambulance ventilation system in non-recirculating mode with the most amount of outdoor air. Use the rear exhaust fan and supplemental recirculating ventilation unit if the vehicle has one. Try to isolate the cab from the rest of the vehicle.
• Let medical personnel know when you think you’ve been exposed to TB. The Ryan White Comprehensive AIDS Resources Emergency Act of 1990 requires that you get notified when you’ve been exposed to a patient with suspected or confirmed TB disease.

Local public health departments look into suspected TB. They also provide treatment for those with TB. If you need information about whether you’ve been exposed, call Wisconsin Department of Health Services (DHS) or your local health department.

For more guidance, view CDC (Centers for Disease Control and Prevention) TB Guidelines.

TB in Wisconsin

Overall, Wisconsin has a low rate of TB. The number of people with TB has decreased each year. You can find TB rates by county and other details through the Wisconsin Tuberculosis Program. The program also has TB nurse consultants who can answer your questions about TB.