Standard Precautions

Question 1

What is the highest risk exposure?

Answer 1

Deep tissue with hollow bore needle containing visible blood

Question 2

What is the lowest risk exposure?

Answer 2

plash to intact skin

Question 3

Hollow or solid bore needle higher risk?

Answer 3

Hollow

Question 4

What needs to be tested post exposure?

Answer 4

Both exposure source and person exposed

Question 5

Should needles be recapped?

Answer 5

No

Question 6

Who do exposures get reported to?

Answer 6

Hospital occupational health services

Question 7

Which diseases are we most concerned about for exposures?

Answer 7

1. HIV
2. HBV
3. HCV

Question 8

Risk of transmission for following serum type:

Needle injury from HBsAg+, HBeAg+ Blood

Answer 8

25% Risk of Hepatitis, 50% Seroconversion

Question 9

Risk of transmission for following serum type:

Needle injury from HBsAg+, HBeAg- Blood

Answer 9

3% Risk of Hepatitis, 25% Seroconversion

Question 10

Treatment in HBV exposure?

Answer 10

1. Unvaccinated: HBIg + HBV vaccine
2. 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

Question 11

Risk of HCV from percutaneous Exposure to Blood from HCV+ source?

Answer 11

1.8% RISK

Question 12

Risk of HBV or HCV higher from infected source?

Answer 12

HBV

Question 13

How to handle HCV exposure?

Answer 13

1. Test baseline and at four to six months with anti HCV and ALT
2. Can perform HCV RNA test at 4-6 weeks
3. No therapy effective in preventing HCV, but treat acute infection aggressively
4. No special sexual precautions advised

Question 14

Treatment in HIV exposure?

Answer 14

1. Baseline HIV test
2. Repeat test 6 weeks, 12 weeks, 6 mos: use of PCR testing not recommended
3. Begin ART ASAP

Question 15

Risk of HIV transmission?

Answer 15

1. Percutaneous Exposure to HIV + Blood = 0.3% RISK

2. Mucocutaneous Membrane exposure to HIV+ Blood = 0.09% RISK

Question 16

What precautions in following scenario:

1. Ptn vomiting blood

Answer 16

Put on everything

Question 17

What precautions in following scenario:

2. Routine daily bedside eval on 33 y/o woman with acute leukemia

Answer 17

gloves or nothing

Question 18

What precautions in following scenario:

3. Draw CBC and electrolytes on GI patient

Answer 18

– gloves

Question 19

What precautions in following scenario:

4. Listening to lungs of ventilated patient

Answer 19

– mask with face shield and gloves

Question 20

What precautions in following scenario:

5. Patient with AIDS post-appendectomy for routine exam, not touching would –

Answer 20

• gloves, but don’t have to because you’re not touching the wound

Question 21

What precautions in following scenario:

6. Uncontrolled diarrhea (unknown if it is infectious or not)

Answer 21

– put on mask, gloves, gown, and put pt in isolation

Question 22

What precautions in following scenario:

7. Trauma team and mass casualty brought to ER

Answer 22

– gown, facemask, gloves

Question 23

What precautions in following scenario:

8. Dealing with body fluid non-contaminated with blood

Answer 23

– wash hands, no special precautions for cleaning up spill

Question 24

What precautions in following scenario:

9. Bloody 6 hour procedure

Answer 24

– waterproof gown

Question 25

What precautions in following scenario:

Vaginal delivery, no prenatal care, high on cocaine and you puncture yourself

Answer 25

d. Pt is tested for HCV, HBV, HIV. Wash your hands, report exposure