Accidental Exposure in the ED – needlestick/splash

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Steps to follow in the event of a needle stick or body fluid exposure  (updated 4/13/21)

 

  1. Protect and discard all sharps. Immediately notify the attending. Wash the exposure site with soap and water (or if eye splash, use water irrigation.)
  2. Ask the attending to draw HIV and hepatitis serologies from the source patient with their permission and record the MRN.
  3. Inform the charge nurse of your unit and request an incident report. If after hours (5pm-8am) or the charge nurse doesn’t have the document, contact AOD (4-HELP).
  4. Fill out the indecent report (It will need to be signed by the provider who sees you)
  5. Get evaluated by an MD or APP (PA/NP):
    1. During business hours (8a-4p M-F) go to Employee Heath (4-3030) with your incident report form and tell them what happened.
    2. After hours and weekends register at internal triage in the ED to open an ED visit. Confirm that the clerk listed “worker’s comp.”
  6. What test should you have done?
    1. Baseline CBC, BMP, LFTs
    2. HIV, Hepatitis B/C serologies, HCV RNA PCR.
  7. Should you start PEP? That depends on the situation. You should discuss the risks/benefits of starting PEP with your provider. If starting PEP, they should give you 1 week supply of the appropriate medications.
  8. Follow up
    1. If the source patient is known to be positive for HIV or hepatitis B or C, you should be scheduled for an appointment with ID “ambulatory referral to EL Virology” for the next business day.

Otherwise;

  1. If you were seen in OHS, they will help arrange your follow up.
  2. If you were seen in the ED, go to OHS during walk-in hours listed on their door on the next business day – earlier is better. 

Note: Rotating residents (including MSSM) should make their first visit at Elmhurst OHS if the incident occurred at Elmhurst.

  1. Make a copy of the incident report for yourself.
  2. Give the incident report to Fabio Martich (B1-27) to be sent to OHS. Note: If you don’t complete an incident report you are going to receive a bill from the city that cannot be voided without the report.

 

If you have any questions, please contact ED leadership.