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TJ/C/0002/01: Annex:1
Reference Policy: Management of needle
Stick injury and other potential exposures:
By medical officer
Reviewed date: 22/08/2013
 

Assess the exposed person according to following guideline

1. Type of exposure
• Percutaneous injury • Mucus membrane exposure 2. Type and amount of tissue /blood
• Other potentially infectious material – CSF, Pleural or pericardial fluid, Amniotic fluid ,semen ,vaginal secretions, respiratory secretions 3. The following tests should be performed on source person (Patient) if known after
obtaining the consent. The consent should be taken by the ward medical officer
4. Evaluation of exposed person (HCW). Consent should be taken when obtaining blood
for testing
• Assess the Hep B /C status – H/O hepatitis B or C • If all 3 doses of Hep B is taken and immune status is not known do Hep B antibody
5. Management for HIV exposure
• If the source person is negative for above infections baseline tests or follow up tests are not necessary for the exposed person. • If source person refuses testing consider the clinical diagnosis and history of risky • If the source is unknown consider as high risk exposure TJ/C/0002/01: Annex:1
Reference Policy: Management of needle
Stick injury and other potential exposures:
By medical officer
Reviewed date: 22/08/2013
Exposure code (EC)
Is the source material blood, body fluid, other potentially infectious material (OPIM), or an instrument contaminated with one of these substances
No PEP required

Type of exposure?
Less Severe
More severe(e.g.
Small Volume
Large Volume
TJ/C/0002/01: Annex:1
Reference Policy: Management of needle
Stick injury and other potential exposures:
By medical officer
Reviewed date: 22/08/2013
Source Code (SC)
Determination of PEP Recommendation
PEP Recommendation
Consider basic regimen (negligible risk) Recommend basic regimen (most exposures are in this If setting suggests a possible risk (epidemiological risk factors and EC is 2 or 3, consider basic regimen) TJ/C/0002/01: Annex:1
Reference Policy: Management of needle
Stick injury and other potential exposures:
By medical officer
Reviewed date: 22/08/2013
 
6. Post exposure Prophylaxis (PEP) for HIV
• Basic regimen- Zidovudine- 200mg8 hrly /300mg 12 hrly • Lamivudine 150mg 12 hrly • Expanded regime- • Zidovudine - 200mg 8 hrly /300mg 12 hrly • Lamivudine -150mg 12 hrly • Refer the exposed person to National STD/AIDS Control program for counseling. I nitiate PEP as soon as possible (within few hou s of exposure).Continue for 4 weeks. Monitor the HCW for evidence of drug toxicity.
7. Post exposure prophylaxis for HBV

Vaccination and
Treatment
antibody response
status of exposed
Previously vaccinated
Known responder
Known non
responder
Antibody response
Hepatitis B immunoglobulin dose is 0.06 ml/kg intramuscularly
If exposed person gives a H/O Hep B infection – No post exposure prophylaxis is necessary
TJ/C/0002/01: Annex:1
Reference Policy: Management of needle
Stick injury and other potential exposures:
By medical officer
Reviewed date: 22/08/2013
 
8. Follow up testing

onths and 6 months /if an illness compatible with an 2) Advice regarding prevention of secondary transmission during the follow up period Anti-Hep Bs for person received vaccination 8.4. The medical officer should fill the exposure report (Attachment II of Management of needle stick/sharp injuries and other potential exposure policy)  

Source: http://www.asiri.info/intranet/images/sampledata/mypdf/jci/ash/Attachment.pdf