BOSTON, MA – Not taking any chances when it comes to his patient’s and his very own health, July intern Reed Evans plans to rule out tuberculosis (TB) in his hospitalized patient not with three negative AFB sputum samples but 99 negative AFB sputum samples.
“You can’t be too cautious in these patients, TB is a very serious condition,” Evans (we think) told Gomerblog. He was difficult to understand as he was quadruple-gloved, quadruple-gowned, and quadruple N95-masked, even while he stood fifty feet outside the patient’s isolation room. “Better to be safe than sorry, you know?”
This is opposite to the approach most seasoned residents would take. Back in April, Gomerblog reported on University of Alabama third-year medicine resident Mitch Milburn and his wise decision to take his chances on a small N95 mask since finding a regular N95 mask required some degree of effort.
It’s hard to argue with Evans though. Evans’ patient is a 33-year-old female with asthma presenting with non-productive & non-bloody cough, chest tightness, and wheezing after recent exposure to dust and perfume. She has zero risk factors for TB. A recent HIV test and PPD last week at her primary care physician’s office was negative.
“Great job!” Evans told his patient, seeing that she had produced her first AFB sample. “All I need is for you to do that 98 more times and if they’re all negative I’ll be confident you don’t have TB, though I will probably give Pulmonary a call anyway to bronch you just in case. You never know, right? But then after that we can discharge you home in no time.”
In related news, Evans plans to check in on his 19-year-old low-probability chest pain patient still with his four layers of personal protective equipment on. “We only need 93 more troponins and he’ll be ready to go too!”