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7 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Risk of acquiring infection after percutaneous occupational exposure to blood borne virus (by %) for HIV, Hep B and Hep C are...
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HIV - 0.3%
Hep C - 3% Hep B - 30% See side three |
These risks are modifed by the following factors identified in the Risk Assessment Stratification Protocol (for HIV)
A) Source population e.g. known HIV status - AIDS vs. asymptomatic, unknown - high/low risk populations B) Innoculum type - fresh blood, other high risk fluid (semen/vaginal fluid), old blood, low risk fluid C) Method transmission - IV, deep IM, deep v superfic transcut, mucosal contact, intact skin |
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Prevention NSI involves
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Universal application of standard precautions:
PPE - gloves (blood/body fluid contact), masks and protective eyewear (if splash/spray potential e.g. procedure), gowns Correct handling and disposal of needles - 100% attention when handling, don't recap/sheath, immediate disposal into convenient sharp bin, don't overfill bill |
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What hospital level interventions should be in place to prevent and manage NSI?
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Infection control program - multidisciplinary, staff health, OH&S, ID, ED, laboratory etc.
Education re: prevention (see previous card) Policies and procedures in event of NSI, disseminated and accessible to staff - consent and testing source - counselling, testing and f/u of individual |
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Occupational exposure is a medical emergency requiring timely management. A staff member has just received a NSI from a known HepB positive patient. What will you do now?
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Initial mx - wash area well with soap and water. Consider tetanus prophylaxis. Document including incident reporting.
Notify infection control Consent and arrange testing of source = HBsAg (if not previously known), HIV and Hep C. Consent and arrange testing of exposed person - same tests as above plus AntiHBsAg (establishes vaccination efficacy if previously vaccinated), If exposed not immunised or not adequately immunised, give Hep B Ig, aim for less than 2/24, definitely within 72 hours. If adequately immunised (= titre > 10mIU/mL) then reassure. If not adequately immunised also repeat course vaccination. Serology for HIV 6/52, 3/12, HCV 3/12, HBsAg 6/12. Advise of hepatitis Sx (seroconversion) Staff support, counselling and confidentiality. |
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Overnight, your 23 yo intern has just got an NSI from an ABG needle used on an HIV pt who presents unwell w cerebral toxoplasmosis. The source refuses consent for blood tests. Your intern has been vaccinated for HBV and responded serologically. What do you do now?
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Obtain baseline serum from intern
Commence antretrovirals - expaned regimen = basic regimen (zidovudine and lamivudine) + PI such as lopinavir/ritonavir Aim for antiretrovirals w/in one hr but maybe effective up to 72 hrs. Provide support/counselling/instructions (report febrile illness, safe sex, avoid preg, don't donation blood) Report incident Specialist f/u w/in 72 hrs |
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T or F
Percutaneous mucosal or cutaneous exposure to urine or saliva never requires PEP T or F PEP may be used with percutaneous innoculation from source with unknown HIV status T or F HBIG may be a consideration in those exposed to unknown HBV status T or F Community blood or body fluid exposures rarely requires PEP |
all True
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T or F
Percutaneous mucosal or cutaneous exposure to urine or saliva never requires PEP T or F PEP may be used with percutaneous innoculation from source with unknown HIV status T or F HBIG may be a consideration in those exposed to unknown HBV status T or F Community blood or body fluid exposures rarely requires PEP |
all True
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