Harbor:Occupational exposure
- Employee Health Guidance Video
- Exposure during weekdays (non-holidays), from 7:00a-3:30p:
- Send employee directly to Employee Health office for evaluation unless the employee has sustained an injury that warrants ED evaluation (i.e. laceration)
- Goal time from exposure to Employee Health office < 15 minutes
- Exposure during all other times:
- Employee with potential blood-borne pathogen exposure should be evaluated in ED
- Charge RN has the exposure packet (needs to be filled out to avoid employee getting the bill)
- Use autotext .edExposure for documentation template and guidance text on when to consult HIV service
- Source patient: Orchid Blood or Body Fluid Exposure - Source Patient order set includes:
- HIV Antibody/antigen screen
- Hepatitis B Surface Antigen
- HCV Quantitative Dx Assay
- Consent not needed if lab already has blood sample to add on test
- If source patient refuses HIV, it can be added on to a pre-existing blood specimen but the results may not be shared with the patient (HIV=gold top ... as is chem, LFT, TSH)
- Employee
- Ensure employee has Hep B vaccine
- No blood testing of the employee in the ED for privacy reasons
- Call HIV service if the source patient's Rapid HIV is positive or is untestable AND was a clinically meaningful exposure (see .edExposure autotext)
- If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health the next day; first dose can be given in the ED
- PEP must be prescribed to the Harbor Pharmacy to avoid generating a bill for the employee (patient)
- Employee with potential blood-borne pathogen exposure should be evaluated in ED