Charge RN has the exposure packet (needs to be filled out to avoid employee getting the bill)
Use autotext ".edexposureharbor" for documentation template and guidance text on when to consult HIV service
Source patient: Employee's supervisor should tell the source patient's provider to order Rapid HIV, Hep B Surface Antigen and Hep C RNA “HCV RNA RT_PCR Quantitative-PHL” using "Blood or Body Fluid Exposure - Source Patient" orderset on source patient (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
Employee: ensure employee has Hep B vaccine; no blood testing of the employee in the ED for privacy reasons
Call HIV service if source patient 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)
Message Erika Sweet at Employee Health after any exposure to ensure follow-up
Additional info in "INDUSTRIAL ACCIDENTS" section below

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
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

References

HUCLA

Authors: