AeroMed Air Purifiers Help Transform Health Clinic into Chest Clinic Specializing in TB

The AeroMed ATC is a negative pressure, aerosol treatment chamber or booth, that is most often used for sputum induction.

2008-05-13 09:27:22 - A NJ health clinic strategically implements air purification equipment to transform clinic space for treatment of TB patients while staying within budget. Creates negative pressure rooms with HEPA exhaust and installs sputum induction booth to complete transformation from ambulatory care clinic to TB clinic.

While the rate of tuberculosis (TB) cases within the United States remain near all time lows, the high global rate of TB serves as a constant reminder of the potential threat that this disease represents. Without maintaining an aggressive policy towards identifying and treating this disease, it is very possible that the rate of active TB cases in the US could begin to rise again. In today's lean economy with its budget constraints and government cutbacks, it is challenging for health departments to create space that is specially configured to treat TB patients and to protect staff and other patients from transmission of TB disease.

The State of New Jersey in partnership with Camden County Health Department, has recently commissioned a chest clinic specializing in TB. Rather than build a new, dedicated facility, they have transformed an existing ambulatory care clinic into a specialty chest clinic, in part through the strategic application of HEPA air purification.

The State of New Jersey has an aggressive program to reduce the rate of TB statewide which has been mostly successful in recent years. According to Tom Privett, NJ Department of Health, TB Program Manager, 'one of the problems this success has created is an unfamiliarity of dealing with TB on the part of many physicians within the state.' This lack of experience dealing with TB could lead to a resurgence of the disease through mishandling of cases. In an attempt to address this possibility, the State of NJ has created regional chest clinics that specialize in TB so that experienced TB phycisians will be located strategically throughout the state. There was not enough need though to build a brand new facility in the southern region so the state sought out existing space that could be transformed for this use.

After a long search for a desirable location in southern NJ, the state was contacted by Nancy Gerrity, the Director of Public Health Nursing for the Camden County Department of Health. She made them aware of an underutilized ambulatory care clinic in Bellmawr, NJ that may meet their needs. There were some challenges and concerns since the facility was not designed for this use. The clinic shared its building with the local public library and also shared space with planned parenthood services and a women and children nutritional supplement program. They would need to ensure that safeguards were installed that would protect their neighbors as well as the other clinic occupants from potential exposure to TB.

To provide the necessary protection, it was determined that two negative pressure exam rooms would be created for providing care to TB patients. Negative pressure is created by ensuring that more air is exhausted from a space than is supplied to that space. This pressure differential creates a draw of air into the room that dramatically reduces the potential for contaminated air to leave that room. The pressure differential is continually monitored by a room pressure device to ensure that the room is operating properly whenever it is being used for cases requiring isolation. Due to the close proximity of the library to the health clinic, all air that is exhausted from the exam rooms is passed through HEPA filters prior to being exhausted out of the clinic. Factory tested HEPA filters are used to ensure that the filters are operating at 99.99% against a 0.3 micron size challenge agent. The HEPA filters are installed in a well sealed housing to ensure that no contaminated air can bypass the filter and be exhausted, untreated to outside of the clinic.

As part of services provided to TB patients, the clinic may perform a diagnostic test called a 'Sputum Induction'. In this test a patient is made to inhale an aerosol that irritates the lungs, inducing the patient to cough so that a sputum sample from deep within the lungs can be obtained. Since the last thing that staff wants to do is to have a patient with a potentially airborne infectious disease coughing in an open space, this test is performed in an aerosol treatment chamber (or sputum induction booth). A sputum booth is a small negative pressure chamber meant to accommodate only one person. All air exhausted from this chamber is drawn through a HEPA filter (tested and sealed as described above) before being exhausted back into the room. Performing this procedure in a booth rather than a room protects the staff administering the test while not requiring them to wear a respirator (which they would have to do if the test was performed in a negative pressure room). The sputum booth is also equipped with a continuous room pressure monitor to ensure that it is always under negative pressure when in use.

To ensure that the equipment continues to perform as designed and is able to protect the staff and neighbors from infection, the facility has contracted their local air filter distributor (Custom Air Controls, Inc.) to service the equipment on a quarterly basis. This will provide independent confirmation that the rooms are providing proper protection.

Other upgrades or additions made to the facility include a contract to provide enhanced laboratory services, a state of the art centrifuge so that the new QuantiFERON TB test can be administered, and a new state of the art portable x-ray machine that transmits x-rays by DSL to physicians off site for immediate expert analysis.

While these other upgrades are technically significant and impressive, it was the 'best practices' application of air filtration solutions that transformed this ambulatory care clinic into a safe place where these vital services could be administered. AeroMed products used in this solution package include two AeroMed AM600C ceiling mount air purifier, two AeroMed AM-TRK room pressure monitors and one AeroMed AM-ATC Aerosol Treatment Chamber (sputum booth).

AeroMed products include HEPA air purifiers that may be portable, ceiling mounted, wall mounted or inline with duct work. AeroMed also provides sputum booths, UV light fixtures, room pressure monitors and smoke test bottles. For more information on how AeroMed products can be used to upgrade you facility please visit AeroMed on the WEB at www.myAeroMed.com or call (518)843-3500.