[STUDY] Postexposure Evaluation and Follow-up

What happens post exposure?

Exposure

Wash/flush area

• Squeezing putting antiseptic, bleach does not reduce infection risk

Report

• Infection control officer

• Document date and time

Medical evaluation

Postexposure prophylaxis (PEP) if needed

Follow up testing

Healthcare personnel (HCP)

Anyone working in healthcare who may be exposed to blood or infectious materials

Occupational exposure

Percutaneous injury

• Punctures skin

  • Needle stick

  • Scalpel

• High risk

Mucous membrane exposure

• Blood or OPIM splashes into eyes, nose, mouth

Nonintact skin

• Blood contacts damaged skin

Human bite?

Post exposure prophylaxis (PEP)

• Given after exposure to prevent infection

• Within 2 hours

Includes

• Vaccines

• Immune globulins

• Antiviral drugs

• Antibiotics

Source patient

Evaluate source patient for hepatitis B, hepatitis C, HIV

• History of infection

Hepatitis B

If not vaccinate

• HBIG or vaccine within 24 hours

• Must receive HBV PEP

• If fully vaccinated — no HBV PEP needed

Hepatitis C

• NO PEP

• Instead — testing and follow up within 48 hours

• 3—6 weeks RNA test

• 4—6 months Anti HCV

Human Immunodeficiency Virus (HIV)

• PEP works best if started ASAP

• PEP - 3+ antiviral drugs within 72 hours

  • If negative — discontinue pep

MMR (airborne or direct contact)

Measles

• MMR vaccine within 72 hours

• or immune globulin with 6 days

Mumps

• MMR vaccine but develops too slow

• Immune globulin not rec

Rubella

• No PEP

• Immune globulins reduce but not eliminate

• Monitor

Herpes simplex virus (HSV)

• NO PEP

Varicella (direct contact or droplets)

• Varicella vaccine asap within 3—5 days

• If no vaccine — give VZIG within 96 hrs

Human papillomavirus (HPV)

• Transmitted through cuts, abrasion, mucosa

• No pep

Influenza

• annual flu vaccine

• PEP or antivral meds

• Oseltamivir

COVID

No pep

Tuberculosis (TB)

TST (skin test)

IGRA (blood test)

Diphtheria

PEP includes

• Td or Tdap

• Antibiotics

Pertussis

• 1 lifetime Tdap

• Booster every 10 years

Meningococcal disease

High risk close contacts receives

• Antibiotic PEP

Pneumococcal

• No pep

MRSA

No pep

Hep A

Give hep A vaccine