Difference between revisions of "Healthcare occupational exposure to blood or other body fluids"
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Rapid HIV, hep pannel, RPR?
Rapid HIV , hep pannel, RPR?
CBC, C7, LFTs,
Revision as of 04:27, 15 January 2015
- Frequently from needlestick injuries or other occupational exposures to bodily fluids
- 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 labs
- Rapid HIV, hep pannel, RPR?
- Exposed labs
- risk of infc 2- 30% after needle stick
- can survive on dried blood for 1 wk
- found in all fluids but highest conc in blood and therefore highest risk with blood
- hep b surface antibodies confers life long immunity
- don't need to test pt or source if pt certain fully/ successfully immunized- antibodies > 10 IU at some time
- if pt not successfully immunized, give hep b immune globulin
- failed 3 shots/ 1 series- give hep booster and immune globulin x 2 doses over 1 mo
- failed 6 shots/ 2 series- give sequential immune globulin
Patient Unvaccinated, Source Pos --> HBIG + vaccine
- no prophylaxsis
- no interferon, no antivirals, no globulin
- not xmitted efficiently through needle stick- 2% rate
- get basline hcv test and ALT
Post Exp Viral Hep Counseling
- can still breast feed
- no organ/ blood donation
- no worry about modifiying sex pattern or becoming preg
- Harbor: Occupational Exposure