Section 13 - Procedure for Occupational Exposure to Blood and Bodily Fluids

The Student Health Center (SHC) offers post-exposure care to Health Science students or SHC staff that have an occupational exposure to blood or other body fluids that may contain HBV/HIV.

A.  Immediately following the exposure:

Wounds or skin sites exposed to blood or other body fluids should be washed thoroughly with soap and water; mucus membranes should be flushed with water.  The incident should be immediately reported to the supervisor who will complete a departmental accident report indicating: date and time of occurrence; details of the procedure being performed and how the exposure occurred; a description of the immediate post-exposure care provided in the department; and details about the exposure source. The report should indicate the HIV status of the source-person, or whether the source material contained HIV or other blood borne pathogens.  If the source-person is HIV positive, the report should indicate the stage of disease, history of antiretroviral therapy, and viral load, if known.  The exposed person should be given a copy of the departmental report and advised to seek immediate post-exposure medical care at the SCH, a family physician, a local urgent care clinic, or a local hospital emergency room.

B. If the exposed person presents to the SCH:

  1. The exposed person will present their Lamar I.D. and the departmental accident report. SHC staff will initiate an Exposure Report (see 2.7a) and make a chart for the patient if one does not already exist.
  2. The physician or nurse practitioner will evaluate the injury and document his/her findings on the departmental accident report, and in the patient chart utilizing the Exposure Report.
  3. A blood specimen will be obtained for HBV/HIV testing immediately, at 6 weeks, 12 weeks, and 6 months post exposure, or at any time during the first 6 months if the exposed person develops an illness compatible with an acute retroviral syndrome.  The exposed person should be advised to immediately report any febrile illness that occurs during the first 6 months post exposure.
  4. If the exposed person is a student, the cost of the lab work will be billed to their student account.
  5. If the exposed person could be pregnant, a serum pregnancy should also be performed with the initial lab work.  In the event the exposed person is pregnant, immediate referral to their obstetrician is indicated for recommendations regarding post-exposure prophylaxis (PEP) and follow-up care.    
  6. SHC staff will inform the exposed person it is their responsibility to return the SHC for subsequent testing.  Should the exposed person desire follow-up at another location, he or she should be given a copy of the Centers for Disease Control and Prevention (CDC) guidelines (2.7 b 1, 2, 3), and any appropriate records.
  7. If the HIV status of the source-person is unknown, serious attempts should be made to obtain testing of that individual immediately.
  8. SHC staff will inform the exposed person that occupational exposure carries a low risk for HIV transmission but that they should use the following measures to prevent secondary transmission during the follow-up period: use sexual abstinence or condoms to prevent sexual transmission and to avoid pregnancy; refrain from donating blood, plasma, organs, tissue, or semen; and if breastfeeding, discontinue and contact their pediatrician immediately.
  9. SHC medical staff will offer post-exposure counseling or licensed counselors as needed.

C. Post-exposure Prophylaxis (PEP):

The physician or nurse practitioner will determine the need for post-exposure prophylaxis for HBV/HIV on an individual basis, based on the type of body substance involved and the route and severity of the exposure.  The decision will be grounded on the CDC guidelines (2.7 b 1, 2, 3).  If it is determined that PEP is needed for a health science student, SHC staff will obtain the required medication from a local pharmacy and bill the student account.  If the exposed person is a SHC employee, the required medication will be purchased by the SHC.

(COMPLETE RECOMMENATIONS AND REPORT FROM THE CDC LOCATED IN THE APPENDIX OF THE SHC POLICY AND PROCEDURE MANUAL)

D.  Patient Information Following Occupation Exposure to Blood or Body Fluids: 

Occupational exposure carries a low risk for HIV transmission, however, the Centers for Disease Control and Prevention recommends the following precautions after an occupational exposure to blood or body fluids:

  1. Evaluation for hepatitis B (HBV) and human immunodeficiency virus (HIV) should be performed immediately, and at 6 weeks, 12 weeks, and 6 months post exposure.
  2. Any febrile illness occurring within the first 6 months post exposure should be immediately evaluated.
  3. To prevent possible secondary transmission during the follow-up period, the following measures should be observed:
  • Use sexual abstinence or condoms to prevent sexual transmission and to avoid pregnancy.
  • Refrain from donating blood, plasma, organs, tissue, or semen.
  • If breast-feeding, discontinue immediately and contact your pediatrician.

Counseling regarding medical and/or psychosocial issues is available to you at the Student Health Center (880-8466).  You may also contact the AIDS Hotline at 1-800-342-AIDS.