Steps to follow in the event of a needle stick or body fluid exposure (updated 4/13/21)
- Protect and discard all sharps. Immediately notify the attending. Wash the exposure site with soap and water (or if eye splash, use water irrigation.)
- Ask the attending to draw HIV and hepatitis serologies from the source patient with their permission and record the MRN.
- 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).
- Fill out the indecent report (It will need to be signed by the provider who sees you)
- Get evaluated by an MD or APP (PA/NP):
- During business hours (8a-4p M-F) go to Employee Heath (4-3030) with your incident report form and tell them what happened.
- After hours and weekends register at internal triage in the ED to open an ED visit. Confirm that the clerk listed “worker’s comp.”
- What test should you have done?
- Baseline CBC, BMP, LFTs
- HIV, Hepatitis B/C serologies, HCV RNA PCR.
- 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.
- Follow up
- 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;
- If you were seen in OHS, they will help arrange your follow up.
- 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.
- Make a copy of the incident report for yourself.
- 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.