Harbor:Occupational exposure

Main Topics

• Occupational Exposure
• HIV Prophylaxis (Occupational)

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
  • Have provider for source patient call Employee Health at x2360
    • Gives NP in Employee Health a contact in case of labs need to be drawn on source patient
  • Do not draw any labs on source patient, unless asked to do so by the NP in Employee Health
• Exposure during all other times:
  • Employee with potential blood-borne pathogen exposure should be evaluated in ED
  • Obtain OCCUPATIONAL EXPOSURES-ED form (see below)
  • Use form to guide you in assessment of risk and need for testing
  • If exposure warrants rapid HIV test on the source patient, then must give source patient opportunity to opt out of HIV test
  • Only contact HIV service if:
    • Source patient has capacity and opts out OR
    • Source patient lacks capacity
  • Check Affinity for recent (weeks or months) HIV results on source patient
• When to call HIV service:
  • Must fill out form and present exposure case to ED attending prior to contacting HIV service
  • If source patient is HIV+ AND exposure has potential to transmit HIV
    • HIV+ either by history or if rapid HIV is positive at time of exposure
  • Source patient lacks capacity OR chooses to opt out of HIV test
    • Only HIV service has authority to approve testing in these situations

Resident Duties

• Obtain details of exposure
• Obtain details of source patient
  • Name, MRN, Diagnosis,
  • Prior HIV results in past year?
  • If source patient known to be HIV+ contact HIV service immediately (pager 310-501-4260)
• Order Rapid HIV test on source patient if:
  • Percutaneous injury occured via needle, scalpel, or other sharp object that has been in contact with source patient's blood, body fluid, or tissue
  • Mucosal splash to eyes, mouth, or into nose involving blood or other body fluid
• Rapid HIV test not indicated on source patient if:
  • Blood or body fluid came into contact with employee's intact skin
  • Employee exposure involved patient's saliva, urine (unless visible blood is present in saliva or urine)
  • Employee exposure to needle, scalpel or other sharp object that had NOT been in contact with patient's blood, body fluid, or tissue

Forms

Occupational Exposure form p.1

Occupational Exposure form p.2

Source

HUCLA