Difference between revisions of "Healthcare occupational exposure to blood or other body fluids"

(HIV Risk)
(Hepatitis B)
Line 32: Line 32:
 
===Hepatitis B===
 
===Hepatitis B===
 
*Not normally indicated, assuming patient has had full course of Hepatitis B vaccination (as all healthcare workers should have)
 
*Not normally indicated, assuming patient has had full course of Hepatitis B vaccination (as all healthcare workers should have)
**If not vaccinated, see [[Hepatitis_B#Hepatitis_B_Post-Exposure_Prophylaxis|Hepatitis B Post-Exposure Prophylaxis]]
+
**If exposed-patient NOT vaccinated, see [[Hepatitis_B#Hepatitis_B_Post-Exposure_Prophylaxis|Hepatitis B Post-Exposure Prophylaxis]]
  
 
===Hep C===
 
===Hep C===

Revision as of 20:00, 19 November 2017

Background

  • The majority of persons (e.g. source patients) chronically infected with hepatitis B and C (65% to 75%) are not aware of their infection [1]

Clinical Features

  • Frequently from needlestick injuries or other occupational exposures to bodily fluids

Differential Diagnosis

Evaluation

  • In many systems, a standardized baseline lab panel is sent in the ED and then followed up at employee health the next day
  • Frequently, the only actionable lab on the day of exposure is a rapid HIV test from the source patient (for consideration of PEP)

Source-patient labs

  • Rapid HIV, hepatitis panel, RPR?
  • Hepatitis B and C infectivity of source patient
    • HBs-Ag (active infection)
    • HBc-Ab IgM (window period)
    • HepC-Ab, plus or minus viral load

Exposed-patient labs

  • Most require NO laboratory testing
  • If giving HIV PEP:
    • Rapid HIV
    • CBC, C7, LFTs, pregnancy test

Management

HIV

Hepatitis B

  • Not normally indicated, assuming patient has had full course of Hepatitis B vaccination (as all healthcare workers should have)

Hep C

  • No prophylaxis regimen has any benefit

Disposition

  • Outpatient management with employee health follow-up

See Also

References