護理師進入病房照顧疑似患有活動性肺結核(TB)的病人。護理師必須穿戴哪種個人防護裝備(PPE)?
A nurse is entering a room to care for a client with suspected active pulmonary tuberculosis (TB). Which personal protective equipment (PPE) is mandatory for the nurse?
- ASurgical mask外科口罩
- BN95 respirator✓ 正解N95 呼吸器
- CFluid-resistant gown防液體隔離衣
- DGoggles and face shield護目鏡與面罩
肺結核(TB)是典型的空氣傳播(Airborne transmission)疾病。結核桿菌會隨飛沫核懸浮在空氣中,其顆粒極小(<5微米),一般的醫療外科口罩無法過濾這些微小粒子。因此,護理師必須佩戴經過密合度測試(Fit-tested)的 N95 呼吸器,以確保吸入的空氣經過高效過濾。除了 N95 之外,這類病人應安置在負壓隔離病房(AIIR),每小時至少進行 6-12 次空氣交換。護理師在進入病房前必須先戴好 N95,離開病房並關上門後才可摘除。這是為了防止懸浮在空氣中的病菌進入呼吸道。若只是進行一般照護且無噴濺風險,手套和隔離衣並非強制,但 N95 是絕對必要的最低防護要求。
An N95 respirator is mandatory for healthcare workers entering the room of a client with suspected active pulmonary tuberculosis because TB is transmitted via airborne droplet nuclei that are too small for surgical masks to filter. The respirator must fit tightly to ensure effective protection against inhalation of infectious particles. While gowns and gloves may be used based on specific contact precautions, the N95 is the critical barrier for airborne isolation.
美國 OSHA 規定醫療人員必須每年進行 N95 Fit Test(密合度測試),確保型號適合臉型。台灣雖然也要求 N95,但在密合度測試的落實頻率與標準化上,各醫院差異較大,且有時會用「鴨嘴型」或「圓型」口罩替代,但在 NCLEX 中必須選擇 N95。