Mantoux test setting
Tuberculin diagnostics, or Mantoux test, is carried out in order to select a contingent of patients for vaccination and revaccination of BCG, as well as to detect tuberculosis and infection with Mycobacterium tuberculosis.
Indications for Mantoux test
Appointment of a doctor in accordance with the vaccination schedule:
- from 1 to 7 years - 2 times a year (the interval between the Mantoux test is 6 months);
- from 7 years and older - 1 time per year (interval - 12 months).
Contraindications for Mantoux test
- Acute somatic and infectious diseases.
- Exacerbations of chronic diseases.
- Allergic conditions in any manifestations.
- Epilepsy.
Period less than 1 month after vaccination.
Equipment
- Tuberculin syringe 1.0 ml.
- Tuberculin in standard dilution.
- Needle number 085.
- Fine needle with a short cut No. 0415.
- Sterile tweezers.
- 70% ethyl alcohol.
- Sterile cotton balls.
- Transparent millimetric ruler.
- Mask, gloves, containers with disinfectant.
- Medical documentation - registration forms 112 / y (child development history) or 025 / y (outpatient card), f.063 / y - preventive vaccination card, for organized children - f.026 / y.
Sequencing
We wash our hands, put on a mask, gloves.
We open the ampoule with tuberculin.
We draw 0.2 ml of tuberculin into the syringe using a needle No. 085.
Using tweezers, we change the needle No. 085 to the needle No. 0415, the needle removed from the syringe is placed in a container with disinfectant.
We release the tuberculin solution from the syringe to the 0.1 mark into a sterile cotton ball, which is immediately placed in a container with a disinfectant solution.
We treat the patient's skin in the region of the middle third of the anterior surface of the forearm with a sterile cotton ball moistened with 70% alcohol twice. In an even year, the Mantoux test is carried out on the right hand, in an odd year - on the left.
We wait 1-2 seconds for the skin to dry or wet it with a sterile cotton ball.
We insert the needle with the cut up into the upper layer of the skin parallel to its surface, that is, intradermally . We introduce the drug in an amount of 0.1 ml, which is equal to 2 TU (tuberculin units). With the correct injection technique, a papule - an infiltrate - of a whitish color with a diameter of about 8 mm, the so-called "lemon peel" is formed in the skin.
We warn the mother, child or adult patient that the injection site should not be wetted, combed, or injured.
The needle and syringe are placed in special labeled containers with disinfectants.
Remove gloves, also immerse them in a disinfectant solution.
Necessarily! We make a mark in the history of the development of the child (or an outpatient card) and in the registration form No. 063 (and in f.026 / y for organized children).
Accounting for the results of the Mantoux test
The result is evaluated 72 hours after the procedure.
We measure the diameter of the papule or hyperemia perpendicular to the axis of the hand with a transparent colorless millimeter ruler.
In the presence of both papule and hyperemia, only the size of the papule is taken into account. The size of hyperemia is taken into account only in the absence of papule.
Necessarily! The result is recorded in the history of the development of the child or the card of the outpatient, as well as in the form No. 063 / y (if necessary, also in the form No. 026 / y).
Evaluation of the results of the Mantoux test
- Negative: the complete absence of papule and hyperemia, or the presence of a prick reaction.
- Doubtful - papule 2-4 mm or hyperemia of any size.
- Positive - papule of 5 mm or more.
- Hyperergic - papule 17 mm or more, reactions with screening, necrosis, the presence of vesicles, regardless of the size of the papule.
It is important to remember that the Mantoux test is a very responsible procedure and requires the nurse to have clear knowledge of the manipulation, as well as maximum composure and responsibility.
