University of Delaware
Department of Environmental Health & Safety
Post-Exposure Evaluation and Follow-Up Procedure
1. 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 9-911 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. 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.
4. Contact DEHS (831-1433 or 831-8475) with information regarding the incident AS SOON AS POSSIBLE. To notify DEHS of an exposure after normal business hours, call Public Safety at 831-2222 and ask that DEHS be contacted. The employee will be referred to a medical provider approved by DEHS. If the employee desires, they may go to their own personal physician rather than the provider designated by DEHS. It is the responsibility of the employee to provide DEHS with the name and address of the personal physician prior to the first visit so DEHS 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 DEHS; contact DEHS to determine the appropriate healthcare provider for the exposure. Timely evaluation by a healthcare provider may minimize the complications from an exposure.
5. 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 DEHS as soon as
possible. Follow appropriate reporting procedures within the injured
individual's department as well.
6. As soon as feasible fill out the Exposure Report
Form. Forms are available at DEHS. 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. DEHS will send the other
necessary information, as required by the OSHA BBP Standard, regarding
the exposure to the medical provider.
7. 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."
8. 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.
9. The exposed individual will be evaluated by the
medical provider, including testing for HBV and HIV serological status if
the individual consents.
10. 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.
11. The medical provider will furnish DEHS 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.
12. 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.
EHS 2/99
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University of Delaware, October 1997.
