Harbor:Occupational exposure: Difference between revisions

(Text replacement - "== " to "==")
(Modified occupational exposure management)
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*'''Exposure during all other times:'''
*'''Exposure during all other times:'''
**Employee with potential blood-borne pathogen exposure should be evaluated in ED
**Employee with potential blood-borne pathogen exposure should be evaluated in ED
**Obtain '''OCCUPATIONAL EXPOSURES-ED''' form (see below)
**Create and use "Occupational Exposure" dot-phrases to guide evaluation, assess risk, need for testing, and indications for obtaining ID/HIV consult
**Use form to guide you in assessment of risk and need for testing
**If exposure warrants rapid HIV test on the source patient, then must give source patient opportunity to opt out of HIV test
**If exposure warrants rapid HIV test on the source patient, then must give source patient opportunity to opt out of HIV test
**Only contact HIV service if:
***Source patient has capacity and opts out OR
***Source patient lacks capacity
**Check Affinity for recent (weeks or months) HIV results on source patient
*'''When to call HIV service:'''
**Must fill out form and present exposure case to ED attending prior to contacting HIV service
**If source patient is HIV+ AND exposure has potential to transmit HIV
***HIV+ either by history or if rapid HIV is positive at time of exposure
**Source patient lacks capacity OR chooses to opt out of HIV test
***Only HIV service has authority to approve testing in these situations
==Resident Duties==
[[File:OE harbor2.jpeg|thumb|Occupational Exposure form p.1]]
[[File:OE harbor1.jpeg|thumb|Occupational Exposure form p.2]]
*Obtain details of exposure
*Obtain details of source patient
**Name, MRN, Diagnosis
**Prior HIV results in past year?
**'''If source patient known to be HIV+ contact HIV service immediately''' ('''pager 310-501-4260''')
*Order Rapid HIV test on source patient if:
**'''Percutaneous injury''' occured via needle, scalpel, or other sharp object '''that has been in contact with source patient's blood, body fluid, or tissue'''
**'''Mucosal splash''' to eyes, mouth, or into nose involving blood or other body fluid
*Rapid HIV test not indicated on source patient if:
**Blood or body fluid came into contact with employee's intact skin
**Employee exposure involved patient's '''saliva, urine''' (unless visible blood is present in saliva or urine)
**Employee exposure to needle, scalpel or other sharp object that had '''NOT been in contact with patient's blood, body fluid, or tissue'''
*Ordering rapid HIV on source patient:
**Place rapid HIV order in source patient's chart
**VERIFY rapid HIV correctly ordered by clerk in the computer (NOT HIV Elisa)
**Notify Blood bank that specimen for rapid HIV is forthcoming '''(x2252)'''
**Check results 1 hour after blood has arrived in blood bank
**FAX filled out form to Employee Health at '''310-222-5326'''


==See Also==
==See Also==

Revision as of 20:03, 22 June 2017

Harbor Management

  • Exposure during weekdays (non-holidays), from 7:00a-3:30p:
    • Send employee directly to Employee Health office for evaluation
      • Except if employee has sustained injury that warrants ED evaluation (i.e. laceration)
    • Goal time from exposure to Employee Health office < 15 minutes
    • Have provider for source patient call Employee Health at x2360
      • Gives NP in Employee Health a contact in case of labs need to be drawn on source patient
    • Do not draw any labs on source patient, unless asked to do so by the NP in Employee Health
  • Exposure during all other times:
    • Employee with potential blood-borne pathogen exposure should be evaluated in ED
    • Create and use "Occupational Exposure" dot-phrases to guide evaluation, assess risk, need for testing, and indications for obtaining ID/HIV consult
    • If exposure warrants rapid HIV test on the source patient, then must give source patient opportunity to opt out of HIV test

See Also

References

HUCLA

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