Body Fluid Exposure

                                                 Body Fluid Exposure Tips (for Providers)

 

Occupation Medicine Clinic (OMC): 

Monday-Thursday 8:00-4:00 pm & Friday 8:00- 12:00 pm.

Occupational Medicine at 909-433-0842 or Employee Health at 909-558-8797 during the week during business hours.

Angela Angelo RN (Exposure Control Nurse for Employee Health Services): Ext. 50262 (contact info in exposure packets also)

Call 24/7 (855) 500-5584 Nurse Advice and Injury Reporting Hotline

 

Currently the location for the initial visit post-exposure would be the Advanced Urgent Care (AUC).  

Obtain thorough history of exposure including source patient history of blood borne pathogen infection, if known, and employee tetanus and HBV vaccination status.

(The exposure report that is contained in the yellow exposure folders asks all the pertinent questions to evaluate the exposure and adheres to OSHA’s BBP Standard.)

 

History to include: 

- Date and time of the exposure incident

- Type of sharp involved in the exposure incident

- Description of the exposure incident, include: job classification of the exposed employee, work area where incident occurred, procedure that the exposed employee was performing at the time of the incident, how it occurred and body part involved in the exposure incident.

 

High risk if:

 

Low risk if: 

 

Provide education, evaluation, and recommendation with regards to PEP medications, Isentress (raltegravir 400mg PO BID) and Truvada (emtricitabine 200mg + tenofovir 300mg PO qday) for 28 days OR until source patient’s HIV test results are negative.

 

PEP prescriptions should be sent to the LLU Outpatient Medical Center pharmacy and start first dose in AUC/ED. Most common side effect include GI symptoms (i.e. stomach upset, nausea) which typically resolves after the first week of treatment initiation, you may provide supportive therapy with anti-emetics as needed. PEP is also safe in pregnancy and breastfeeding. Prior to starting PEP if exposed employee consents to treatment, obtain following labs CBC, CMP, and pregnancy test (if applicable). HIV Ag/Ab, Hep C Ab, Hep B sAg are performed as part of exposure labs.

**LLU Outpatient MC pharmacy is open 8-8 pm on weekdays and 8-530 pm on weekends.

 

Per ID, there is a higher prevalence of undiagnosed HIV in the San Bernardino area so if the source is unknown HIV with high risk exposure, consider PEP. It is better to treat if unsure since the medication safety profile outweigh the risks. “Nearly 1/5 of the people living with HIV in our county are unaware of their status, so it's hard to use the history of 'no history of HIV' in this situation.” 

You may reach out to ID on weekdays between 9A-5P or National Clinician’s PEPline at 888-448-4911. MDCalc has HIV Needle Stick RASP score to guide with PEP decisions as well.


**Students should be referred to Student Health 909-558-8770**