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 occupational exposure template https://www.wikem.org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure)
  - 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)
Message Jeremy Ramon at Employee Health after any exposure to ensure follow-up
Additional info in "INDUSTRIAL ACCIDENTS" section below

References

HUCLA

Authors:

Harbor:Occupational exposure

See Also

References