Hello, all,

I would just add that we have collected samples for testing post-mortem. Sometimes this was from our request and sometimes it comes from the coroner after finding suspicious tissue when opening up the body. National Jewish tests those samples for us. The tissue has to be fixed in formalin. We have diagnosed a few of our cases this way. If you want specifics on how to prepare and package, you would have to call your labs to see if they can run the tests and then inquire about their collection and shipping process.

Most importantly, if someone is being worked up for TB disease, it is imperative that the coroner or mortician is notified if that patient dies prior to diagnosis so they can use the proper PPE as well as possibly collect more samples.

Ann Scarpita BSN, MPH

TB Nurse Consultant

Tuberculosis Program

4300 Cherry Creek Drive South, Denver, CO 80246

P 303.692.2656| F 303.759.5538

ann.scarpita@state.co.us

www.colorado.gov/cdphe/tb

"Wisdom is knowing the right path. Integrity is taking it." ~M.H. McKee

NURSING TIPS: When preparing to administer any drug to a client, consider what is often referred to as the "Five Rights" of medication administration:

Right client
Right route
Right drug
Right dose
Right time

A sixth right often mentioned, but not part of the original five, is the right documentation. Don't forget to administer the drug to the client first, and then document. Documenting beforehand is considered falsification of documentation and is a violation of the nurse practice act.

Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.

On Wed, Jan 22, 2020 at 6:03 AM Murphy-Weiss, Maureen A. <MAMurphy-Weiss@columbus.gov> wrote:

Hi Katie,

I just encountered a situation last month where an autopsy identified necrotizing granuloma and we had a similar request. I asked if they followed published biosaftey recommendations for proper PPE during autopsies, and they said they do. If that is the case with your coroner, they are protected if procedures generate small aerosolized particles, as the recommendations include N-95 or PAPR. (There isn’t anything special the coroner should do for TB.) That said, WHO published guidance in 2014 - Infection Prevention and Control of Epidemic- and Pandemic-Prone Acute Respiratory Infections in Health Care, that addresses PPE during autopsy (appendix F). Given the emergence of the SARS-like virus in China it may be helpful to have a refresher for PPE requirements and infection control practices, generally. If you want to talk, please feel free to give me a call at the number below. I am usually in the office until 4:30 EST.

Maureen Murphy-Weiss, BSN, RN

Program Manager II RN

Ben Franklin TB Program

(614) 645-6518

mamurphy-weiss@columbus.gov

Columbus Public Health
240 Parsons Ave, Columbus, OH 43215
www.publichealth.columbus.gov

Facebook / Twitter / YouTube

NOTICE TO UNINTENDED RECIPIENT: The documents accompanying this message contain legally privileged confidential information that belongs to the sender. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient, you are notified that any disclosure, copying, distribution or use of the contents of the information is strictly prohibited. If you have received this message in error, please destroy it immediately.

From: tbnurses@ntca.simplelists.com [mailto:tbnurses@ntca.simplelists.com] On Behalf Of Katie Kelsch
Sent: Tuesday, January 21, 2020 4:49 PM
To: tbnurses@ntca.simplelists.com
Subject: Coroner Training

Hi TB Nurses,

Has anyone completed training for their Coroner on TB? Our Coroner is looking for training when TB is suspected, confirmed, or not on the differential. We spoke with our lab but they didn’t have any special information related to postmortem sample collection.

Thank you for any ideas!

Katie

Katie Kelsch BSN, RN, PHN

Senior Public Health Nurse

Infectious Disease

Community Health Branch (Courier #16CH)

Yolo County Health & Human Services Agency

Email: katie.kelsch@yolocounty.org

Phone: (530) 666-8339

Mobile: (530) 908-5739

Fax: (530) 669-1549 (Confidential)

CONFIDENTIALITY NOTICE: This email and any files transmitted with it are confidential and are intended solely for the use of the individual or entity to which they are addressed. This communication may contain material protected by HIPAA legislation (45 CFR, Parts 160 & 164) or by 42 CFR Part 2. If you are not the intended recipient, be advised that you have received this email in error and that any use, dissemination, forwarding, printing, or copying of this email is strictly prohibited. If you have received this email in error, please notify the sender by reply email and destroy all copies of the original message.

To reply to a posting, simply reply. To start a new thread, address it to
tbnurses@ntca.simplelists.com and put in a concise subject line.
You are on the daily digest setting for the listserve.The archives for
this list are at http://ntca.simplelists.com/tbnurses.
If you have problems with the listserve, please contact NTCA staff at ntca@tbcontrollers.org

To reply to a posting, simply reply. To start a new thread, address it to
tbnurses@ntca.simplelists.com and put in a concise subject line.
You are on the daily digest setting for the listserve.The archives for
this list are at http://ntca.simplelists.com/tbnurses.
If you have problems with the listserve, please contact NTCA staff at ntca@tbcontrollers.org