Risk and treatment:
|
Virus |
Risk |
Treatment |
|
HIV |
0.3% |
· Post-exposure prophylaxis (aim <2, ok <72h) · Suppressive treatment |
|
HCV |
3% |
· Curative treatment |
|
HBV |
30% |
· Vaccine ± booster (give STAT if unvaccinated) |
Post-exposure management:
· Wash +++
· Call infection control: risk assessment + planning
· Test self: HBV surface antigen
· Test patient: HBV, HCV, HIV (need consent)
· ±Treatment
· ±Follow up
· Maintain confidentiality
· Seek support – mentor etc
Risk of transmission dependent upon:
· Extent of injury (deep > superficial)
· Item causing injury (hollow bore > solid)
· Body fluid (blood > other)
· Volume
Respiratory transmission:
|
Droplet (normal mask) |
· Cold · Flu · Pneumonia · Streptococcal throat · Whooping cough |
|
Airborne (N95 mask) |
· SARS · TB · Measles · VZV |
Vaccinations required for:
· HAV
· HBV
· Influenza (70-90% effective)
· DTP
· MMR
· HAV
· BCG (if TB is endemic; only 50% effective)
Standard precautions:
· Safe handling of sharps
· Cough etiquette
· Respiratory hygiene
· Gloves
· Mask
· Goggles
Personal responsibilities:
· Have proof of immunization status
· Know one’s blood-borne virus status
· Inform employer and stop clinical work if infected
· Routine blood tests every 1-2 years (!)
· Should have ‘needle-stick cover’ insurance
Feedback welcome at ketaminenightmares@gmail.com