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B. TUBERCULOSIS SCREENING <br />All inmates will be screened for tuberculosis (TB) within four (4) days of <br />admission into the Jail. The nursing staff will begin by interviewing the <br />inmate to determine his/her reactivity to the tuberculin skin test (TST). <br />Inmates who do not have a verifiable positive test result history will have <br />the TST administered at this time, according to the Mantoux method, with <br />readings taken in 49 to 72 hours. Immune compromised inmates will be <br />anergy tested at the time of the skin test to minimize the risk of a false <br />negative result. <br />Positive TST results will trigger a more extensive examination to <br />determine the likelihood of active disease. Individuals considered positive <br />reactors (by history or skin test) would receive a chest x-ray. The <br />physician, regardless of the skin test result, will examine HIV positive or <br />possible positive, individuals whose chest x-rays are abnormal or whose <br />symptoms are suggestive of active tuberculosis. Sputum stains and <br />cultures will be performed on those individuals suspected of being positive <br />for active tuberculosis. While cultures are pending, the inmate will be <br />housed in respiratory isolation. Confirmed cases of TB will be reported to <br />the proper authorities including the Jail Administrator and the Orange <br />County Department of Public Health. Inmates with inactive tuberculosis <br />will be given future TB testing instructions and education. <br />Screening results will be placed in the inmate's medical record and <br />reviewed and approved by the physician or NP during the health appraisal. <br />C. HEALTH APPRAISAL <br />All inmates will receive a comprehensive medical history and physical <br />examination within fourteen (14) days after admission. The history and <br />exam will be performed by qualified and trained health professionals (if <br />City or Santa Aim Jail -15- <br />Proposel for finale Medical Services <br />RPPA 074)62