|Needlestick / Blood Contamination Protocol|
|1.||Treatment of Exposure|
The site should be decontaminated as soon as safety permits. Open wounds should be washed first with soap and water, then irrigated with sterile saline if available. Splashes to eyes and mucous membranes should be flushed extensively with water 5-10 minutes. There is no evidence that use of antiseptics, caustic agents (bleach) or expressing blood from the wound reduces the risk of infection. The inflammation they cause may potentially facilitate entry of the virus.
Report the Exposure
Students need to report the exposure immediately to their supervisor, and not wait until the end of a procedure. The most knowledgeable person is the charge nurse of that location (OR, ward, clinic). Then call to report:
- Mon-Fri. days-call student health @ 2-3664
- After hours-call MUSC page operator @ 2-2123 for Blood Bourne Pathogen Exposures to students.
|They should see to it that (1) Student Health is notified and (2) Blood is collected on the source patient and sent to the lab for testing. When the infectious status of the source blood is unknown, rapid HIV testing will be performed, and the results paged to Student Health within one hour. If no one seems to know what to do at your location, call Student Health (792-3664) during the day, or after hours have the MUSC operator (792-2123) page the physician covering Blood Borne Pathogen Exposures for students.|
At other Clinical Sites: When a student is exposed while at an off-campus site, the exposure should be reported immediately to their supervisor, to the doctor or head nurse in an office or clinical setting or if in a hospital, to the charge nurse in an OR, ward or clinic. They should see to it that their policy on exposures is followed. The student should call Student Health (792-3664) during the day, or after hours have the MUSC operator (792-2123) page the physician covering Blood Borne Pathogen Exposures for students.
After reporting the exposure to the appropriate person, students should immediately report to or, if away from Campus, call Student Health during normal clinic hours (8:00 am – 4:30 pm) on weekdays. After hours, the physician on call for students will be paged by the House Service Coordinator, head nurse or supervisor, or by the student. The physician on call for the students will talk with the student to assess the nature and risk of the exposure, and follow up on the lab results of the source patient.
Once the nature and risk of the exposure has been assessed, the student will be counseled on their risk of infection, and when appropriate, offer antiviral prophylaxis and/or baseline laboratory testing. Post Exposure Prophylaxis (PEP) with antiviral drugs should be initiated ideally within one hour when the source is a know HIV (+) or when the Rapid HIV test is (+). The risks and benefits of this therapy will be discussed with the student.
After this initial assessment, students are to follow up 2-3 days later to receive the results of the remainder of the source’s lab (hepatitis B antigen, hepatitis C Ab, HIV ELISA) and any baseline lab testing done on the student. Any additional questions or follow up can be addressed at this time.