Standard Precautions Flashcards
What is the highest risk exposure?
Deep tissue with hollow bore needle containing visible blood
What is the lowest risk exposure?
plash to intact skin
Hollow or solid bore needle higher risk?
Hollow
What needs to be tested post exposure?
Both exposure source and person exposed
Should needles be recapped?
No
Who do exposures get reported to?
Hospital occupational health services
Which diseases are we most concerned about for exposures?
- HIV
- HBV
- HCV
Risk of transmission for following serum type:
Needle injury from HBsAg+, HBeAg+ Blood
25% Risk of Hepatitis, 50% Seroconversion
Risk of transmission for following serum type:
Needle injury from HBsAg+, HBeAg- Blood
3% Risk of Hepatitis, 25% Seroconversion
Treatment in HBV exposure?
- Unvaccinated: HBIg + HBV vaccine
- Vaccinated
a. Knownresponder:(anti-HBsinbloodhasbeenmeasured)–Notreatment
b. Known nonresponder: treat as unvaccinated patient with HBIG + HBvaccine
c. Response Unknown: Test exposed for anti-HBs: adequate response, no treatment, inadequate: HBIg and vaccine
Risk of HCV from percutaneous Exposure to Blood from HCV+ source?
1.8% RISK
Risk of HBV or HCV higher from infected source?
HBV
How to handle HCV exposure?
- Test baseline and at four to six months with anti HCV and ALT
- Can perform HCV RNA test at 4-6 weeks
- No therapy effective in preventing HCV, but treat acute infection aggressively
- No special sexual precautions advised
Treatment in HIV exposure?
- Baseline HIV test
- Repeat test 6 weeks, 12 weeks, 6 mos: use of PCR testing not recommended
- Begin ART ASAP
Risk of HIV transmission?
- Percutaneous Exposure to HIV + Blood = 0.3% RISK
2. Mucocutaneous Membrane exposure to HIV+ Blood = 0.09% RISK
What precautions in following scenario:
1. Ptn vomiting blood
Put on everything
What precautions in following scenario:
2. Routine daily bedside eval on 33 y/o woman with acute leukemia
gloves or nothing
What precautions in following scenario:
3. Draw CBC and electrolytes on GI patient
– gloves
What precautions in following scenario:
4. Listening to lungs of ventilated patient
– mask with face shield and gloves
What precautions in following scenario:
5. Patient with AIDS post-appendectomy for routine exam, not touching would –
- gloves, but don’t have to because you’re not touching the wound
What precautions in following scenario:
6. Uncontrolled diarrhea (unknown if it is infectious or not)
– put on mask, gloves, gown, and put pt in isolation
What precautions in following scenario:
7. Trauma team and mass casualty brought to ER
– gown, facemask, gloves
What precautions in following scenario:
8. Dealing with body fluid non-contaminated with blood
– wash hands, no special precautions for cleaning up spill
What precautions in following scenario:
9. Bloody 6 hour procedure
– waterproof gown
