Exposure to BBV's Flashcards
What is a sharps injury
Piercing or breaking of the skin by a needle or sharp object (e.g. probe, scalpel, needle etc.) that is contaminated with blood/body fluids
What is classed as mucocutaneous exposure
Contamination of eyes, nose or mouth with blood/body fluids.
A human bite that breaks the skin.
What is the risk of transmission of HBV after exposure
30% (if HBeAg positive); < 6% (if HBeAg negative)
What is the risk of developing HIV following exposure
0.3% percutaneous exposure
Out of HIV,HCV and HBV which is most prevalent within the general population
HCV
What factors influence BBV exposure
Prevalence of virus in patient population
Type of exposure – per/mucocutaneous
Extent of injury – superficial/deep
Type of device – hollowbore/solid needle/other
Immune status of Health care worker
Immediate aftercare and use of post-exposure prophylaxis (PEP)
When was the surveillance scheme to record significant exposure to BBVs established
1997
What are the most common exposure incidents
Sharps injuries
What does the acronym AWARE stand for
Apply pressure and allow to bleed
Wash dont scrub
Assess type of injury
Risk of source patient blood
Establish contact
What is a significant injury
percutaneous,
human bite with skin broken
exposure of broken skin or mucous membrane to blood or body fluids
What is a high risk material
blood and bodily fluids with visible blood
Saliva
What does establishing constact mean
Report injury promptly to a senior member of staff
Call Occupational Health provider
Record injury (accident book and official reporting)
Employees who have had injuries must be followed up for prophylaxis, counselling and prevention.
What does PEP stand for
Post exposure Prophylaxis
What is HBIG
Hepatitis B immunoglobulin
When should HBIG be administered if needed
At the same time or within 24hrs of the first dose of the vaccine (but not after 7 days have elapsed since exposure)
What is the PEP for HIV
Combined anti-retroviral therapy
Start within 24hrs of exposure (if indicated)
Common side effects include headaches, fever, and nausea
Not routinely recommended if source has confirmed and sustained undetectable viral load
What is the recommendation for post exposure follow ups
As a minimum, follow-up should be for at least 6-12 weeks after the exposure event
If PEP was taken, follow-up should be at least 12 weeks from when PEP was stopped
A negative test at 12 weeks provides a very high level of confidence of freedom from infection.
How are occupational exposures and BBV transmissions prevented
Vaccination
Elimination of unnecessary needles
Sharps containers
Hand hygeine
PEP
No recapping
Rasing awareness
PPE
Recording and reporting
Risk assessment
What modifications do needles have for safer treatment
Syringe with protective sheild
Syringes with retractable needles
Blunt tip blood-drawing needle
Who do the health and safety (sharp instruments in healthcare) regulations 2013 apply to
Employers and employees
Contractors working for healthcare employer
Students/trainees on placement with healthcare employers
Community or hospital pharmacies
What are the main requirements for employers in the health and safety regulations
Promote the safe use and disposal of medical sharps
Provide information and training for employees
Respond effectively if an injury occurs
Review procedures regularly
What are the main requirements of emplyees in the health and safety regulations
An employee who receives a sharps injury at work must notify their employer as soon as practicable (regulation 8)
Supported by
Information and training on what to do in the event of a sharps injury (regulation 6(4))
