Healthcare occupational exposure to blood or other body fluids

Revision as of 04:13, 15 January 2015 by Rossdonaldson1 (talk | contribs)

Workup

  1. Td
  2. Hepatitis B PEP for non-vaccinated
    1. Hepatitis B immunoglobulin and/or vaccine
  3. Source labs
    1. Rapid HIV, hep pannel, RPR?
  4. Exposed labs
    1. Rapid HIV, hep pannel, RPR?
  5. Consider HIV PEP
    1. CBC, C7, LFTs, Icon if considering HIV PEP

^Currently no PEP for Hep C

HIV

Hep B

  1. risk of infc 2- 30% after needle stick
  2. can survive on dried blood for 1 wk
  3. found in all fluids but highest conc in blood and therefore highest risk with blood
  4. hep b surface antibodies confers life long immunity
  5. don't need to test pt or source if pt certain fully/ successfully immunized- antibodies > 10 IU at some time
  6. if pt not successfully immunized, give hep b immune globulin
  7. failed 3 shots/ 1 series- give hep booster and immune globulin x 2 doses over 1 mo
  8. failed 6 shots/ 2 series- give sequential immune globulin

Patient Unvaccinated, Source Pos --> HBIG + vaccine

Hep C

  1. no prophylaxsis
  2. no interferon, no antivirals, no globulin
  3. not xmitted efficiently through needle stick- 2% rate
  4. get basline hcv test and ALT

Post Exp Viral Hep Counseling

  1. can still breast feed
  2. no organ/ blood donation
  3. no worry about modifiying sex pattern or becoming preg


See Also

Source

6/06 MISTRY