POST EXPOSURE
RESPONSE
Introduction
Post- after
Exposure- when fluid containing blood borne
pathogens (HIV, HBV and HCV) comes into contact
with mucous membrane or intact skin.
Procedure/Response- An action after exposure
Post exposure procedures refers to actions taken to
prevent infections/disease after being exposed to
blood borne pathogens (HIV, HBV, HCV)
Exposure contin….
Exposure can be occupational exposure and non
occupation exposure
Occupation exposure refers to exposure to potential
blood borne infections that may occur in health care
setting during performance of job duties.
Types of occupational exposure includes
Percutaneous injury e.g Needle stick injuries, skin
cut
contact of mucous membrane.
Contact of non intact skin
Exposure contin….
Non occupational exposure are exposure outside of the
work place.
Examples of non occupational exposure includes
Needle sharing
Consexual sex
Non consexual sex
Post Exposure Prophylaxis
(PEP)
Post exposure Prophylaxis refers to medical
management to minimize the risk of infection
among health care personnel following potential
exposure to blood borne pathogens.
The aim of PEP is to maximal suppress any limited
viral replication that may occur after exposure.
PEP must be prescribed to people who are HIV
negative and within the last 72 hours after being
exposed.
Personel at Risk for
Exposure
Lab personnel
Nurses
Clinicians
Hospital house keeping staff
Waste disposal workers
Dentist
Patients
Surgeons
Morticians
Level of risk of Exposure
The level of risk of exposure is calculated from combination of the
likelihood and consequences of exposure in given circumstances
Risk vary with type and severity of exposure
High risk
Means the likelihood of exposure to a source is at high possibility
of causing infections. The level of risk to health care workers
exposed to percutaneous exposure is estimated to be high risk
Moderate risk
The likelihood of exposure to a source is at medium possibility of
causing infection. For example the level of risk after exposure to
mucous membrane is estimated to be moderate risk.
. Low risk
The likelihood of exposure to a source gives low risk
of causing infections after exposure. For example the
level of risk after exposure to non intact skin
exposure is estimated to be low risk compared to
percutaneous injury exposure and mucous
membrane exposure
Steps of Post Exposure
Response
i. Treatment of exposed site
Immediately start the following
Wash needle stick injury with 70% ethanol (soap
and water) for 15 minutes
Flush splashes to the nose, mouth for 15 minutes
Irrigate eyes with clean water, saline, sterile
irrigants
Steps contin…
ii. Reporting Exposure
Report injury to supervisor
Complete exposure event form
Note the sample number of specimen exposed
Steps contin…
iii. Evaluation of exposure and exposure sources
type of exposure
Type and amount of fluid
iv. Assessment of infection status of source of
exposure
Test for HIV antibody
For unknown sources, evaluate the likelihood of
exposure to a source at high risk
Steps contin…
v. Susceptibility of exposed person
Administer pre test-HIV counseling
Test for HIV
If female Health care worker test for pregnancy
vi. Administering PEP
Must be administered within 72 hours
Only for eligible personnel who tested HIV
Negative
Steps contin…
vii. Follow up testing and counseling
Repeat HIV test 6 weeks, 3 and 6 month following
exposure
Link to HIV treatment if the test results is postive
Post Exposure protocol for both
occupational and non
Occupational Exposure
Assessment
Clinical assessment of exposure
Eligibility assessment for HIV post exposure
prophylaxis
HIV testing of exposed people and source of
exposure
Provision of first aid in case of broken skin
Protocol contin…
Counseling and support
Risk of HIV
Risk and benefits of HIV Post exposure prophylaxis
Side effects
Enhanced adherence counseling is PEP to be
prescribed
Protocol contin…
Prescription
Post exposure prophylaxis should be initiated as
early as possible following exposure
28 days prescription of recommended age
Drug information
Protocol contin…
Follow up
HIV test at 3 month after exposure
Link to HIV treatment if possible
