Hello everyone!

I do not see patients directly while working at the state so I asked the TST and carrying epinephrine question to a few of the county nurses.

Ann Lund From Whatcom said this and shared the attached article from Canada:

Interesting question. The short answer is no, we do not carry Epi if placing TST in the field, but we do have it available in our office.   I researched this in the past, and relevant data is hard to find, but I found a Canadian journal article with reference estimating serious TST reactions occurring at a rate of about  1 per million  which seems to correlate with general experience of severe anaphylaxis to TST being extremely rare.  Significant blistering and inflammation is a known potential exaggerated reaction to TST that is more common (especially when retesting those previously positive) but is strictly a localized reaction.  I just reviewed Tubersol package insert, and of course to cover liability under Warnings section it does state “Epinephrine injection and other appropriate agents used for control of immediate allergic reactions must be immediately available.”

Lana Kay Tyer, RN MSN

Tuberculosis Nurse Consultant

Office of Communicable Disease Epidemiology

Division of Disease Control & Health Statistics

Washington State Department of Health

Lana.tyer@doh.wa.gov

206-418-5581 | www.doh.wa.gov

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