Harbor:Occupational exposure (dot-phrases) - Revision history

Rossf: /* .edexposure* */

2022-03-29T21:43:51Z

.edexposure*

← Older revision		Revision as of 21:43, 29 March 2022
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	Part 1: Type of Exposure		'''Part 1: Type of Exposure'''

	'''Non-infectious body fluids''' are saliva, sputum, urine, vomitus, nasal secretions, sweat, tears, and feces. However, if these fluids are contaminated with visible blood, then they are to be considered potentially infectious.		'''Non-infectious body fluids''' are saliva, sputum, urine, vomitus, nasal secretions, sweat, tears, and feces. However, if these fluids are contaminated with visible blood, then they are to be considered potentially infectious.
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	Part 2: Details Regarding the Source Patient		'''Part 2: Details Regarding the Source Patient'''

	Full name of source patient: _		Full name of source patient: _
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	D. '''Near zero risk''' because sharp object (e.g., needle or scalpel) did not penetrate skin.		D. '''Near zero risk''' because sharp object (e.g., needle or scalpel) did not penetrate skin.

			[Use this MDM phrase for options A-D above]

	~~[Use this MDM phrase for options A-D above]~~ '''MDM for a near zero risk exposure''': because the exposure is near zero risk there is no indication to determine the HIV status of the source patient or to test for hepatitis B or C.		'''MDM for a near zero risk exposure''': because the exposure is near zero risk there is no indication to determine the HIV status of the source patient or to test for hepatitis B or C.

	E. A '''clinically meaningful exposure''' because it involved a penetrating injury with an object that had been in contact with the patient’s blood or potentially-infectious body fluids.		E. A '''clinically meaningful exposure''' because it involved a penetrating injury with an object that had been in contact with the patient’s blood or potentially-infectious body fluids.
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	G. A '''clinically meaningful exposure''' because it involved a splash to non-intact skin (e.g., broken, disrupted, chapped or abraded skin or skin with active dermatitis) with the patient’s blood or a potentially infectious body fluid.		G. A '''clinically meaningful exposure''' because it involved a splash to non-intact skin (e.g., broken, disrupted, chapped or abraded skin or skin with active dermatitis) with the patient’s blood or a potentially infectious body fluid.

			[Use one of these MDM phrases for options E-G above]

	~~[Use one of these MDM phrases for options E-G above]~~ '''MDM for a clinically meaningful exposure''':		'''MDM for a clinically meaningful exposure''':

	['''If the source patient is already known to be HIV positive based on existing laboratory testing'''] Since the employee suffered a clinically meaningful exposure and the source patient is documented to be HIV positive, we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a '''"Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.~~-Unless the source patient is known to be infected with hepatitis B we will '''obtain a hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee~~		['''If the source patient is already known to be HIV positive based on existing laboratory testing'''] Since the employee suffered a clinically meaningful exposure and the source patient is documented to be HIV positive, we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a '''"Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.

	['''If the source patient’s HIV status is unknown'''] We will obtain a '''rapid HIV antibody test''' from the source patient, after providing them with an opportunity to opt out from testing. If the source patient is unable to participate in an opt-out discussion (sedated, altered, etc.), or if the source patient refuses, according to California law a rapid HIV test can be ordered on an available blood sample, but only in the context of a clinically meaningful exposure. If the source patient is found to be HIV negative, then the employee will be discharged with instructions to follow up in employee health the next business day. If the source patient is found to be HIV positive '''and''' the employee suffered a '''clinically meaningful exposure''', we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will '''obtain a "Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. -Unless the source patient is known to be infected with hepatitis B we will obtain a '''hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee~~. '''We will not perform any laboratory testing on the exposed employee in the ED.'''~~		-Unless the source patient is known to be infected with hepatitis B we will '''obtain a hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee


	Follow up [Select one of A-D and elaborate accordingly]:		['''If the source patient’s HIV status is unknown'''] We will obtain a '''rapid HIV antibody test''' from the source patient, after providing them with an opportunity to opt out from testing. If the source patient is unable to participate in an opt-out discussion (sedated, altered, etc.), or if the source patient refuses, according to California law a rapid HIV test can be ordered on an available blood sample, but only in the context of a clinically meaningful exposure. If the source patient is found to be HIV negative, then the employee will be discharged with instructions to follow up in employee health the next business day. If the source patient is found to be HIV positive '''and''' the employee suffered a '''clinically meaningful exposure''', we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will '''obtain a "Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee.

			-Unless the source patient is known to be infected with hepatitis B we will obtain a '''hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee.

			'''We will not perform any laboratory testing on the exposed employee in the ED.'''


			'''Follow up''' [Select one of A-D and elaborate accordingly]:

	A. Harbor-UCLA Medical Center employees: Employee Health next working day (Send ORCHID message to Erika Sweet)		A. Harbor-UCLA Medical Center employees: Employee Health next working day (Send ORCHID message to Erika Sweet)

Rossf at 21:34, 29 March 2022

2022-03-29T21:34:54Z

← Older revision		Revision as of 21:34, 29 March 2022
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	Is source patient known to be Hepatitis B surface AG positive (yes/no)? _		Is source patient known to be Hepatitis B surface AG positive (yes/no)? _

	~~The patient’s occupational exposure is (pick only one of the following A-G and use the MDM that corresponds to the risk level for the exposure):~~

	~~A. '''Near zero risk''' because it was limited to contact of the source patient’s blood or body fluid on the employee’s intact skin, independent of whether the material was potentially infectious.~~

	~~B. '''Near zero risk''' because it was limited to exposure to a non-infectious body fluid.~~

	~~C. '''Near zero risk''' because it was limited to exposure to a sharp object (e.g., needle or scalpel) that had not been in contact with any potentially infectious body fluid.~~

	~~D. '''Near zero risk''' because sharp object (e.g., needle or scalpel) did not penetrate skin.~~


	[Use this MDM phrase for options A-D above] '''MDM for a near zero risk exposure''': because the exposure is near zero risk there is no indication to determine the HIV status of the source patient or to test for hepatitis B or C.

	~~E. A '''clinically meaningful exposure''' because it involved a penetrating injury with an object that had been in contact with the patient’s blood or potentially-infectious body fluids.~~

	~~F. A '''clinically meaningful exposure''' because it involved a mucosal splash to the eyes, mouth, or nose by the patient’s blood or a potentially infectious body fluid.~~

	G. A '''clinically meaningful exposure''' because it involved a splash to non-intact skin (e.g., broken, disrupted, chapped or abraded skin or skin with active dermatitis) with the patient’s blood or a potentially infectious body fluid.


	~~[Use one of these MDM phrases for options E-G above] '''MDM for a clinically meaningful exposure''':~~

	['''If the source patient is already known to be HIV positive based on existing laboratory testing'''] Since the employee suffered a clinically meaningful exposure and the source patient is documented to be HIV positive, we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a '''"Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.-Unless the source patient is known to be infected with hepatitis B we will '''obtain a hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee

	['''If the source patient’s HIV status is unknown'''] We will obtain a '''rapid HIV antibody test''' from the source patient, after providing them with an opportunity to opt out from testing. If the source patient is unable to participate in an opt-out discussion (sedated, altered, etc.), or if the source patient refuses, according to California law a rapid HIV test can be ordered on an available blood sample, but only in the context of a clinically meaningful exposure. If the source patient is found to be HIV negative, then the employee will be discharged with instructions to follow up in employee health the next business day. If the source patient is found to be HIV positive '''and''' the employee suffered a '''clinically meaningful exposure''', we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will '''obtain a "Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. -Unless the source patient is known to be infected with hepatitis B we will obtain a '''hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee. '''We will not perform any laboratory testing on the exposed employee in the ED.'''


	~~Follow up [Select one of A-D and elaborate accordingly]:~~

	~~A. Harbor-UCLA Medical Center employees: Employee Health next working day (Send ORCHID message to Erika Sweet)~~

	~~B. UCLA Medical Students: UCLA Student Health~~

	~~C. Prehospital Care Providers and Law Enforcement: Refer to their contracted occupational health provider~~

	~~D. Non-employees: Refer to their Primary Care Provider~~

	~~== .OccupationalExposureMDM ==~~
	The patient’s occupational exposure is (pick only one of the following A-G and use the MDM that corresponds to the risk level for the exposure):		The patient’s occupational exposure is (pick only one of the following A-G and use the MDM that corresponds to the risk level for the exposure):

Rossf at 21:34, 29 March 2022

2022-03-29T21:34:35Z

← Older revision		Revision as of 21:34, 29 March 2022
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	Is source patient known to be Hepatitis B surface AG positive (yes/no)? _		Is source patient known to be Hepatitis B surface AG positive (yes/no)? _

	~~The patient’s occupational exposure is (pick only one of the following A-G and use the MDM that corresponds to the risk level for the exposure):~~

	~~A. '''Near zero risk''' because it was limited to contact of the source patient’s blood or body fluid on the employee’s intact skin, independent of whether the material was potentially infectious.~~

	~~B. '''Near zero risk''' because it was limited to exposure to a non-infectious body fluid.~~

	~~C. '''Near zero risk''' because it was limited to exposure to a sharp object (e.g., needle or scalpel) that had not been in contact with any potentially infectious body fluid.~~

	~~D. '''Near zero risk''' because sharp object (e.g., needle or scalpel) did not penetrate skin.~~


	[Use this MDM phrase for options A-D above] '''MDM for a near zero risk exposure''': because the exposure is near zero risk there is no indication to determine the HIV status of the source patient or to test for hepatitis B or C.

	~~E. A '''clinically meaningful exposure''' because it involved a penetrating injury with an object that had been in contact with the patient’s blood or potentially-infectious body fluids.~~

	~~F. A '''clinically meaningful exposure''' because it involved a mucosal splash to the eyes, mouth, or nose by the patient’s blood or a potentially infectious body fluid.~~

	G. A '''clinically meaningful exposure''' because it involved a splash to non-intact skin (e.g., broken, disrupted, chapped or abraded skin or skin with active dermatitis) with the patient’s blood or a potentially infectious body fluid.


	~~[Use one of these MDM phrases for options E-G above] '''MDM for a clinically meaningful exposure''':~~

	['''If the source patient is already known to be HIV positive based on existing laboratory testing'''] Since the employee suffered a clinically meaningful exposure and the source patient is documented to be HIV positive, we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a '''"Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.-Unless the source patient is known to be infected with hepatitis B we will '''obtain a hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee

	['''If the source patient’s HIV status is unknown'''] We will obtain a '''rapid HIV antibody test''' from the source patient, after providing them with an opportunity to opt out from testing. If the source patient is unable to participate in an opt-out discussion (sedated, altered, etc.), or if the source patient refuses, according to California law a rapid HIV test can be ordered on an available blood sample, but only in the context of a clinically meaningful exposure. If the source patient is found to be HIV negative, then the employee will be discharged with instructions to follow up in employee health the next business day. If the source patient is found to be HIV positive '''and''' the employee suffered a '''clinically meaningful exposure''', we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will '''obtain a "Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. -Unless the source patient is known to be infected with hepatitis B we will obtain a '''hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee. '''We will not perform any laboratory testing on the exposed employee in the ED.'''


	~~Follow up [Select one of A-D and elaborate accordingly]:~~

	~~A. Harbor-UCLA Medical Center employees: Employee Health next working day (Send ORCHID message to Erika Sweet)~~

	~~B. UCLA Medical Students: UCLA Student Health~~

	~~C. Prehospital Care Providers and Law Enforcement: Refer to their contracted occupational health provider~~

	~~D. Non-employees: Refer to their Primary Care Provider~~

	~~== .OccupationalExposureMDM ==~~
	The patient’s occupational exposure is (pick only one of the following A-G and use the MDM that corresponds to the risk level for the exposure):		The patient’s occupational exposure is (pick only one of the following A-G and use the MDM that corresponds to the risk level for the exposure):

Rossf: /* .edexposure* */

2022-03-29T21:34:02Z

.edexposure*

← Older revision		Revision as of 21:34, 29 March 2022
Line 58:		Line 58:

	Is source patient known to be Hepatitis B surface AG positive (yes/no)? _		Is source patient known to be Hepatitis B surface AG positive (yes/no)? _

			The patient’s occupational exposure is (pick only one of the following A-G and use the MDM that corresponds to the risk level for the exposure):

			A. '''Near zero risk''' because it was limited to contact of the source patient’s blood or body fluid on the employee’s intact skin, independent of whether the material was potentially infectious.

			B. '''Near zero risk''' because it was limited to exposure to a non-infectious body fluid.

			C. '''Near zero risk''' because it was limited to exposure to a sharp object (e.g., needle or scalpel) that had not been in contact with any potentially infectious body fluid.

			D. '''Near zero risk''' because sharp object (e.g., needle or scalpel) did not penetrate skin.


			[Use this MDM phrase for options A-D above] '''MDM for a near zero risk exposure''': because the exposure is near zero risk there is no indication to determine the HIV status of the source patient or to test for hepatitis B or C.

			E. A '''clinically meaningful exposure''' because it involved a penetrating injury with an object that had been in contact with the patient’s blood or potentially-infectious body fluids.

			F. A '''clinically meaningful exposure''' because it involved a mucosal splash to the eyes, mouth, or nose by the patient’s blood or a potentially infectious body fluid.

			G. A '''clinically meaningful exposure''' because it involved a splash to non-intact skin (e.g., broken, disrupted, chapped or abraded skin or skin with active dermatitis) with the patient’s blood or a potentially infectious body fluid.


			[Use one of these MDM phrases for options E-G above] '''MDM for a clinically meaningful exposure''':

			['''If the source patient is already known to be HIV positive based on existing laboratory testing'''] Since the employee suffered a clinically meaningful exposure and the source patient is documented to be HIV positive, we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a '''"Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.-Unless the source patient is known to be infected with hepatitis B we will '''obtain a hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee

			['''If the source patient’s HIV status is unknown'''] We will obtain a '''rapid HIV antibody test''' from the source patient, after providing them with an opportunity to opt out from testing. If the source patient is unable to participate in an opt-out discussion (sedated, altered, etc.), or if the source patient refuses, according to California law a rapid HIV test can be ordered on an available blood sample, but only in the context of a clinically meaningful exposure. If the source patient is found to be HIV negative, then the employee will be discharged with instructions to follow up in employee health the next business day. If the source patient is found to be HIV positive '''and''' the employee suffered a '''clinically meaningful exposure''', we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will '''obtain a "Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. -Unless the source patient is known to be infected with hepatitis B we will obtain a '''hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee. '''We will not perform any laboratory testing on the exposed employee in the ED.'''


			Follow up [Select one of A-D and elaborate accordingly]:

			A. Harbor-UCLA Medical Center employees: Employee Health next working day (Send ORCHID message to Erika Sweet)

			B. UCLA Medical Students: UCLA Student Health

			C. Prehospital Care Providers and Law Enforcement: Refer to their contracted occupational health provider

			D. Non-employees: Refer to their Primary Care Provider

	== .OccupationalExposureMDM ==		== .OccupationalExposureMDM ==

Rossf: /* .edexposure* */

2022-03-29T21:33:12Z

.edexposure*

← Older revision		Revision as of 21:33, 29 March 2022
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	Is source patient known to be Hepatitis B surface AG positive (yes/no)? _		Is source patient known to be Hepatitis B surface AG positive (yes/no)? _

			== .OccupationalExposureMDM ==
			The patient’s occupational exposure is (pick only one of the following A-G and use the MDM that corresponds to the risk level for the exposure):

			A. '''Near zero risk''' because it was limited to contact of the source patient’s blood or body fluid on the employee’s intact skin, independent of whether the material was potentially infectious.

			B. '''Near zero risk''' because it was limited to exposure to a non-infectious body fluid.

			C. '''Near zero risk''' because it was limited to exposure to a sharp object (e.g., needle or scalpel) that had not been in contact with any potentially infectious body fluid.

			D. '''Near zero risk''' because sharp object (e.g., needle or scalpel) did not penetrate skin.


			[Use this MDM phrase for options A-D above] '''MDM for a near zero risk exposure''': because the exposure is near zero risk there is no indication to determine the HIV status of the source patient or to test for hepatitis B or C.

			E. A '''clinically meaningful exposure''' because it involved a penetrating injury with an object that had been in contact with the patient’s blood or potentially-infectious body fluids.

			F. A '''clinically meaningful exposure''' because it involved a mucosal splash to the eyes, mouth, or nose by the patient’s blood or a potentially infectious body fluid.

			G. A '''clinically meaningful exposure''' because it involved a splash to non-intact skin (e.g., broken, disrupted, chapped or abraded skin or skin with active dermatitis) with the patient’s blood or a potentially infectious body fluid.


			[Use one of these MDM phrases for options E-G above] '''MDM for a clinically meaningful exposure''':

			['''If the source patient is already known to be HIV positive based on existing laboratory testing'''] Since the employee suffered a clinically meaningful exposure and the source patient is documented to be HIV positive, we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a '''"Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.-Unless the source patient is known to be infected with hepatitis B we will '''obtain a hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee

			['''If the source patient’s HIV status is unknown'''] We will obtain a '''rapid HIV antibody test''' from the source patient, after providing them with an opportunity to opt out from testing. If the source patient is unable to participate in an opt-out discussion (sedated, altered, etc.), or if the source patient refuses, according to California law a rapid HIV test can be ordered on an available blood sample, but only in the context of a clinically meaningful exposure. If the source patient is found to be HIV negative, then the employee will be discharged with instructions to follow up in employee health the next business day. If the source patient is found to be HIV positive '''and''' the employee suffered a '''clinically meaningful exposure''', we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will '''obtain a "Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. -Unless the source patient is known to be infected with hepatitis B we will obtain a '''hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee. '''We will not perform any laboratory testing on the exposed employee in the ED.'''


			Follow up [Select one of A-D and elaborate accordingly]:

			A. Harbor-UCLA Medical Center employees: Employee Health next working day (Send ORCHID message to Erika Sweet)

			B. UCLA Medical Students: UCLA Student Health

			C. Prehospital Care Providers and Law Enforcement: Refer to their contracted occupational health provider

			D. Non-employees: Refer to their Primary Care Provider

	== .OccupationalExposureMDM ==		== .OccupationalExposureMDM ==

Rossf: /* .edexposureharbor* */

2022-03-29T21:31:04Z

.edexposureharbor*

← Older revision		Revision as of 21:31, 29 March 2022
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	''See [[Harbor:Occupational exposure]] for main discussion''		''See [[Harbor:Occupational exposure]] for main discussion''

	== .~~edexposureharbor~~* ==		== .edexposure* ==
	Nature of occupational exposure: [delete non-applicable sections and instructions in square brackets “[]” when complete; '''DO NOT''' send any blood tests on the exposed employee; complete all applicable sections]		Nature of occupational exposure: [delete non-applicable sections and instructions in square brackets “[]” when complete; '''DO NOT''' send any blood tests on the exposed employee; complete all applicable sections]

Rossf: /* .OccupationalExposureMDM */

2022-03-10T22:01:24Z

.OccupationalExposureMDM

← Older revision		Revision as of 22:01, 10 March 2022
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	[Use this MDM phrase for options A-D above] '''MDM for a near zero risk exposure''': because the exposure is near zero risk there is no indication to determine the HIV status of the source patient or to ~~send a~~ hepatitis C ~~viral load test on the source patient~~.		[Use this MDM phrase for options A-D above] '''MDM for a near zero risk exposure''': because the exposure is near zero risk there is no indication to determine the HIV status of the source patient or to test for hepatitis B or C.

	E. A '''clinically meaningful exposure''' because it involved a penetrating injury with an object that had been in contact with the patient’s blood or potentially-infectious body fluids.		E. A '''clinically meaningful exposure''' because it involved a penetrating injury with an object that had been in contact with the patient’s blood or potentially-infectious body fluids.
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	[Use one of these MDM phrases for options E-G above] '''MDM for a clinically meaningful exposure''':		[Use one of these MDM phrases for options E-G above] '''MDM for a clinically meaningful exposure''':

	['''If the source patient is already known to be HIV positive based on existing laboratory testing'''] Since the employee suffered a clinically meaningful exposure and the source patient is documented to be HIV positive, we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a "Hepatitis C Viral Load - PHL" test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.		['''If the source patient is already known to be HIV positive based on existing laboratory testing'''] Since the employee suffered a clinically meaningful exposure and the source patient is documented to be HIV positive, we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a '''"Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.-Unless the source patient is known to be infected with hepatitis B we will '''obtain a hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee

	['''If the source patient’s HIV status is unknown'''] We will obtain a rapid HIV test from the source patient, after providing them with an opportunity to opt out from testing. If the source patient is unable to participate in an opt-out discussion (sedated, altered, etc.), or if the source patient refuses, according to California law a rapid HIV test can be ordered on an available blood sample, but only in the context of a clinically meaningful exposure. If the source patient is found to be HIV negative, then the employee will be discharged with instructions to follow up in employee health the next business day. If the source patient is found to be HIV positive '''and''' the employee suffered a '''clinically meaningful exposure''', we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a "Hepatitis C Viral Load - PHL" test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.		['''If the source patient’s HIV status is unknown'''] We will obtain a '''rapid HIV antibody test''' from the source patient, after providing them with an opportunity to opt out from testing. If the source patient is unable to participate in an opt-out discussion (sedated, altered, etc.), or if the source patient refuses, according to California law a rapid HIV test can be ordered on an available blood sample, but only in the context of a clinically meaningful exposure. If the source patient is found to be HIV negative, then the employee will be discharged with instructions to follow up in employee health the next business day. If the source patient is found to be HIV positive '''and''' the employee suffered a '''clinically meaningful exposure''', we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will '''obtain a "Hepatitis C Viral Load - PHL"''' test on the source patient, for use in follow up care of the exposed employee. -Unless the source patient is known to be infected with hepatitis B we will obtain a '''hepatitis B surface antigen''' on the source patient, for use in follow up care of the exposed employee. '''We will not perform any laboratory testing on the exposed employee in the ED.'''


	Follow up [Select one of A-D and elaborate accordingly]:		Follow up [Select one of A-D and elaborate accordingly]:

	A. Harbor-UCLA Medical Center employees: Employee Health next working day		A. Harbor-UCLA Medical Center employees: Employee Health next working day (Send ORCHID message to Erika Sweet)

	B. UCLA Medical Students: UCLA Student Health		B. UCLA Medical Students: UCLA Student Health

Rossf: /* .edexposureharbor* */

2022-03-10T21:55:23Z

.edexposureharbor*

← Older revision		Revision as of 21:55, 10 March 2022
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	For all exposures, provide a narrative account of how the exposure occurred and what steps the employee took following the exposure (e.g., soap/water, eyewash): _		For all exposures, provide a narrative account of how the exposure occurred and what steps the employee took following the exposure (e.g., soap/water, eyewash): _

	Has the employee completed a vaccine series for Hepatitis B (yes/no)? _		Has the employee completed a vaccine series for Hepatitis B (yes/no) and had a reactive HBsAb(yes/no)? _

Rossf: /* .edexposureharbor* */

2022-02-28T22:38:57Z

.edexposureharbor*

← Older revision		Revision as of 22:38, 28 February 2022
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	Is source patient known to be Hepatitis C Ab positive (yes/no)? _		Is source patient known to be Hepatitis C Ab positive (yes/no)? _

	If yes, is source patient known to be Hepatitis C RNA positive (yes/no)? _		If yes, is source patient known to be Hepatitis C RNA or viral load positive (yes/no)? _

	Is source patient known to be Hepatitis B surface AG positive (yes/no)? _		Is source patient known to be Hepatitis B surface AG positive (yes/no)? _

Rossf at 22:29, 28 February 2022

2022-02-28T22:29:07Z

← Older revision		Revision as of 22:29, 28 February 2022
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	[Use this MDM phrase for options A-D above] '''MDM for a near zero risk exposure''': because the exposure is near zero risk there is no indication to determine the HIV status of the source patient or to send a hepatitis C ~~antibody~~ test on the source patient.		[Use this MDM phrase for options A-D above] '''MDM for a near zero risk exposure''': because the exposure is near zero risk there is no indication to determine the HIV status of the source patient or to send a hepatitis C viral load test on the source patient.

	E. A '''clinically meaningful exposure''' because it involved a penetrating injury with an object that had been in contact with the patient’s blood or potentially-infectious body fluids.		E. A '''clinically meaningful exposure''' because it involved a penetrating injury with an object that had been in contact with the patient’s blood or potentially-infectious body fluids.
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	[Use one of these MDM phrases for options E-G above] '''MDM for a clinically meaningful exposure''':		[Use one of these MDM phrases for options E-G above] '''MDM for a clinically meaningful exposure''':

	['''If the source patient is already known to be HIV positive based on existing laboratory testing'''] Since the employee suffered a clinically meaningful exposure and the source patient is documented to be HIV positive, we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a ~~hepatitis~~ C ~~antibody~~ test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.		['''If the source patient is already known to be HIV positive based on existing laboratory testing'''] Since the employee suffered a clinically meaningful exposure and the source patient is documented to be HIV positive, we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a "Hepatitis C Viral Load - PHL" test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.

	['''If the source patient’s HIV status is unknown'''] We will obtain a rapid HIV test from the source patient, after providing them with an opportunity to opt out from testing. If the source patient is unable to participate in an opt-out discussion (sedated, altered, etc.), or if the source patient refuses, according to California law a rapid HIV test can be ordered on an available blood sample, but only in the context of a clinically meaningful exposure. If the source patient is found to be HIV negative, then the employee will be discharged with instructions to follow up in employee health the next business day. If the source patient is found to be HIV positive '''and''' the employee suffered a '''clinically meaningful exposure''', we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a ~~hepatitis~~ C ~~antibody~~ test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.		['''If the source patient’s HIV status is unknown'''] We will obtain a rapid HIV test from the source patient, after providing them with an opportunity to opt out from testing. If the source patient is unable to participate in an opt-out discussion (sedated, altered, etc.), or if the source patient refuses, according to California law a rapid HIV test can be ordered on an available blood sample, but only in the context of a clinically meaningful exposure. If the source patient is found to be HIV negative, then the employee will be discharged with instructions to follow up in employee health the next business day. If the source patient is found to be HIV positive '''and''' the employee suffered a '''clinically meaningful exposure''', we will contact the HIV service (310-501-4260) for guidance regarding post exposure prophylaxis. Unless the source patient is known to be infected with hepatitis C we will obtain a "Hepatitis C Viral Load - PHL" test on the source patient, for use in follow up care of the exposed employee. We will not perform any laboratory testing on the exposed employee in the ED.