After Accidental Exposure

Healthcare Worker’s Responsibilities

Self Administer First Aid

  • Needlestick or slash: encourage bleeding and wash area with antibacterial soap and water
  • Mucous membrane splash: flush well with water or saline
  • Skin: wash well with an antibacterial soap
  • Eyes: flush well with water or saline for at least 15 minutes

Seek Medical Attention

  • Monday to Friday, 0800-1600 hours, contact Employee Health
    • Victoria General and Cobequid Site call (902) 473-4666
    • All other sites call (902) 465-8455
  • If Employee Health is not open, nursing staff may evaluate risk if exposed to blood or body fluids. Risk is evaluated through patient history and/or current HCV, HIV and HBsAg results. If history is insufficient, contact the medical delegate to determine risk, order HbsAg, HCV, and HIV on patient
  • Outside Employee Health hours report to the Emergency Department if patient is a HIV known positive, high risk, or if source is unknown. Notify Employee Health on the next business day
  • Report the incident by calling (902) 473-SAFE (7233)

Workplace Prevention

Prevention is key and precautions should be taken whenever handling any contaminated materials.

  • Follow universal precautions at all times
  • Use safe work practices:
    • Handle sharps with care
    • Use the no touch technique in the operating room
    • Know the location of the nearest sharps disposal container before using a disposable sharp
    • Dispose of used sharps immediately, never leave on counter or at bedside
    • Avoid overfilling sharps containers
    • Do not recap used needles (if necessary to recap, a one-handed scoop technique should be used)
    • Wear gloves, although they do not prevent percutaneous injury, they can reduce contact with body fluids
    • Receiving the Hepatitis B vaccine can provide immunity against HBV. The vaccine is given in three doses over six months. It is available through Emergency Department to any employee who is potentially exposed to blood or body substances in their job

Follow-Up

  • If a healthcare worker is exposed to Hepatitis B virus and has not had the Hepatitis B vaccine, it will be recommended. The Hepatitis B immune globulin, which provides passive (immediate) immunity post-exposure, will also be recommended
  • If the healthcare worker has received the Hepatitis B vaccine series and hasn’t had an antibody level done in the last year, they will be advised to have their immune status checked
  • There is no vaccine to prevent Hepatitis C or HIV
  • If a healthcare worker is exposed to Hepatitis C virus, blood work for Hepatitis C is recommended at zero, three and six months
  • If a healthcare worker is exposed to HIV, they will be evaluated for post-exposure prophylaxis (PEP). Evaluation is based on the patient history and the type of injury. A high risk exposure includes either a high viral load in the source material and/or injury from a large hollow-bore needle that has been in a patient’s vein or artery and length of exposure time. Mucous membrane exposures present a lower risk. PEP oral medication is recommended as soon as possible after high risk exposure
  • Blood work for HIV will be done on the healthcare worker at zero, three and six months
    If taking PEP additional blood work (ALT, AST, CBC, diff and CK) is recommended at two and four weeks and HIV at 12 months.
    See policy CH 80-070 regarding Accidental Exposure to Blood and/or Potentially Infectious Body Substances - Employee