Training Process

Medical students will be taught how to perform a basic TB screening test. This involves two parts: placing and reading a PPD (purified protein derivative.) These trainings are held twice a year, once in the fall and once in the spring. Before volunteering at a TB screening clinic, it is required that a medical student attends one of these two trainings. In addition to learning how to place and read PPD’s, these trainings will include general demographic information regarding the prevalence of TB in New Orleans, the pathology of TB, etc.

Before placing a PPD, medical student volunteers will assist each patient is completing a questionnaire to assess the patient’s risk for having TB. This questionnaire asks questions regarding

If the patient has any active symptoms of TB (ex: night sweats, coughing up of blood, etc.)

If the patient has any risk factors that predispose them to having TB (ex: HIV status, previous incarceration, etc.)

After completing the questionnaire, volunteers will place the PPD via an intradermal injection. Within 48-72 hours, the patient will return to the clinic to have their PPD read. For more details on placing and reading tuberculosis PPD’s, please see https://www.ncbi.nlm.nih.gov/books/NBK214439/

If a patient has a “positive” TB screening test, they will be referred to Wetmore TB Clinic, which is overseen by Dr. Amy Wolfe, MD. At Wetmore, the patient will a) receive further testing to confirm they are infected with TB, and b) receive treatment for TB (if applicable.) For more information on Wetmore, please see http://ldh.la.gov/index.cfm/directory/detail/4852/catid/192

Annually, the TB Screening Clinics undergo a risk assessment to ensure medical student safety. Should an event such as an accidental needle stick occur, the TB leader who is present will make sure the volunteer receives immediate treatment. The TB leader will also make sure that the volunteers have safe transportation to and from the clinic.

There has yet to be a medical student infected with TB through volunteering at Tulane’s TB screening clinics. Besides the protocols in place to minimize the risk of students contracting TB, the pathophysiology of TB also accounts for the minimal risk of medical students becoming infected with TB. Regarding the pathophysiology of TB, there are two stages of TB: active and latent.

Active TB is when the patient is infectious. It means that the TB bacteria are replicating within the patient, causing symptoms such as coughing up of blood, chest pain, night sweats, fevers and chills, etc. Encountering a patient with active TB is very rare (less than 1 per year in all of Tulane’s TB screening clinics.) However, should a patient have suspected active TB, they are immediately refereed to the emergency room. Additionally, the patient is given a respirator to prevent the spreading of bacteria from him or her to the medical student.

Latent TB is when the patient is not infectious. During this phase, the TB bacteria are dormant within the patient’s lungs. In essence, the bacteria are “sleeping” and thus not infectious. If a patient has TB at one of our clinics, it is most likely the latent form. This latent form will be detected by the PPD screening test, enabling the patient to receive care before the TB becomes active/infectious.

Scrubs (green preferred), close-toed shoes, stethoscope (as needed).