Difference between revisions of "Healthcare occupational exposure to blood or other body fluids"
(→HIV Risk) |
(→Hepatitis B) |
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===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 | + | **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
Contents
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
- Laceration
- Retained foreign body
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
Management
HIV
- Consider HIV post-exposure prophylaxis
Hepatitis B
- Not normally indicated, assuming patient has had full course of Hepatitis B vaccination (as all healthcare workers should have)
- If exposed-patient NOT vaccinated, see Hepatitis B Post-Exposure Prophylaxis
Hep C
- No prophylaxis regimen has any benefit
Disposition
- Outpatient management with employee health follow-up