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Post-Exposure Evaluation and Follow-Up Procedure1. If an exposure occurs, first determine if emergency medical help is required. Examples of when emergency medical help would be required are excessive bleeding, loss of consciousness, and broken bones. If emergency medical help is required, call 911 for police or ambulance on the campus. 2. For a non-life-threatening emergency, administer first aid. Allow a penetrating injury to bleed. Wash the injury site thoroughly with soap and water or rinse the exposed mucous membrane thoroughly with water. If anyone assists with first aid they should wear gloves. An apron or gown and eye protection may be necessary if a potential for splashing exists. It is the University's policy that personal protective equipment appropriate for the potential hazard is worn, but it is recognized that in certain emergency situations this may not be possible. 3. Any exposure that occurs must be treated immediately. Preventive treatment for HIV exposures, if indicated, should be started within 2-3 hours of the exposure. If you are sent to a clinic or emergency room, make it clear that you have had a bloodborne exposure so you receive timely care. 4. The source of the exposure should be identified if possible, without causing further injury to anyone else. This could simply mean identifying the patient from whom the specimen came. 5. Contact DOHS (831-1433 or 831-8475) with information regarding the incident AS SOON AS POSSIBLE. To notify DOHS of an exposure after normal business hours, call Public Safety at 831-2222 and ask that DOHS be contacted. If you do not receive a call back from DOHS immediately, you can call the Student Health Service at 831-2226 and speak to a nurse there. The Health Service can contact a physician after hours. The employee will be referred to a medical provider approved by DOHS. If the employee desires, they may go to their own personal physician rather than the provider designated by DOHS. It is the responsibility of the employee to provide DOHS with the name and address of the personal physician prior to the first visit so DOHS can provide the physician with the necessary information prior to the treatment of the employee. An injured student may be referred to Student Health or to the medical provider approved by DOHS; contact DOHS to determine the appropriate healthcare provider for the exposure. Timely evaluation by a healthcare provider may minimize the complications from an exposure. 6. If an exposure occurs at a clinical location, follow their procedures for reporting the exposure at the facility if indicated. The facility may test the source patient and/or the exposed individual. The exposure must still be reported to the DOHS as soon as possible. Follow appropriate reporting procedures within the injured individual's department as well. 7. As soon as feasible fill out the Exposure Report Form. Forms are available at DOHS. If possible, the employee or student will take a copy of it to the medical provider when they are referred. Otherwise, it will be sent as soon as possible. DOHS will send the other necessary information, as required by the OSHA BBP Standard, regarding the exposure to the medical provider. 8. Following the exposure, appropriate paperwork must be filed. An injured employee must complete the "Employer's Report of Occupational Injury or Disease." An injured student must complete a "First Report of Injury." The employee, supervisor, or safety committee for the injured subject must complete an "Accident/Loss Investigation Report." 9. The source individual's blood, or material the individual was exposed to, may be tested to determine HBV and HIV status. This shall be done in accordance with the Delaware Annotated Code, title 16, Sections 1202 and 1203. 10. The exposed individual will be evaluated by the medical provider, including testing for HBV and HIV serological status if the individual consents. 11. Post-exposure prophylaxis, when medically indicated, counseling, and evaluation of reported illnesses will be performed by the medical provider. The medical provider shall inform the exposed individual of any test results, including those performed on the source individual, if such tests were run. 12. The medical provider will furnish DOHS with a written opinion for hepatitis B vaccination limited to whether hepatitis B vaccination is indicated for the employee, and if the employee has received the vaccination. The written opinion will also include that the employee has been informed of the results of the evaluation, and that the employee has been told about any medical conditions resulting from the exposure which require further evaluation or treatment. 13. Any follow-up care will be provided by the approved medical provider or the employee's personal physician if they so elect. Any treatment or follow-up care resulting from the exposure shall be at no cost to the employee. All exposure follow-ups shall remain confidential.
If you have any questions regarding these procedures, or about bloodborne pathogens or other biosafety issues, please contact Krista Murray, Biosafety Officer, via e-mail at Klmurray@udel.edu, or by phone at 831-1433. |
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