3. Exposure
OCCUPATIONAL EXPOSURE that may
place a worker at risk of HIV infection is a
percutaneous injury ,contact of mucous
membrane or contact of skin (especially when
the skin is chapped, abraded or affected with
dermatitis or the contact is prolonged or
involves an extensive area ) with blood tissue or
other body fluids to which universal precautions
apply.
Institute of Infectious Diseases
5. Why this helpline ?
The needle stick injury can not only lead to some life
threatening blood borne infections as well as have
severe emotional impact on health care personnel.
It is an medical emergency and can happen anywhere
anytime
FOGSI initiative is first of its kind in world
Institute of Infectious Diseases
6. What is the extent of the problem ?
Survey of 428 HCW in India
- 343 (80%) had 1 PI in past 1
year (IJMR, April,2010)
In USA there are 57 documented
cases of health care workers
contracting
HIV
from
exposures; 137 other possible
cases
(NEJM 2003;348:826)
Institute of Infectious Diseases
7.
8. Rationale of PEP
Information about primary HIV infection
indicate that systemic infection does not occur
immediately leaving a brief period within ‘window
of opportunity’ during which post exposure antiretroviral intervention may modify viral replicaiton
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9. Principle behind administering PEP
Surface ligands of
dendritic cells of skin
or mucous membrane
CD4 CELL
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10. WHAT TO DO ON EXPOSURE
It is a medical emergency
Do not panic
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11. WHAT NEXT
REPORT PROMPTLY
PEP MUST START AT THE EARLIEST
PREFERABLY WITHIN TWO HOURS
MAY BE UPTO 72 HOURS
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12. How to assess risk ?
The exposure report
(Each exposure is unique)
•
Date and time of exposure
Accurate report: Minute to minute details are ideal
Procedure details…what, where, how, with what
device
Exposure details...route, body substance involved,
volume/duration of contact
Information about source person and exposed
person
Exposure management details
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16. How helpline works
A call is received from an exposed health care
worker by Dr Alok Vashishtha, Specialist in
HIV/AIDS on his cell. He then follows
following procedure:
Details of exposure are taken
A protocol is decided
ARV drugs are made available (if required)
Follow up is done as decided
Have a team of resource persons for complex
scenarios
17. How drugs are made available
Have a memorandum of understanding with all
companies making and marketing HIV drugs.
Dr Alok Vashishtha have the mobile numbers of
National Sales manager of all companies in field
of HIV therapy.
Their pan India sales network of about 2500
executives is used to locate the pharmacy
catering these drugs.
Address is given to the exposed health care
provider
18.
19. Type of calls
Call from around all states of India
Call from Asia, Africa, Europe and USA.
Problem phone calls (General query about
HIV/AIDS)
Special kind of exposures
Missed calls
Stigma calls
For locating a OBGYN
20. Conclusions
Health care workers put themselves at risk in their work
Prevention of exposures is critical
PEP can be useful intervention
Management of occupational exposure is complex
Expert consultation should be sought
Finally
Awareness of Universal precautions and PEP options:
- allay fears of caring for HIV infected persons
- reduced stigma and discrimination
- better care of PLHIV
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21. HELP LINE TEAM
Dr. Narendra Malhotra
Dr. C.N. Purandare
Dr. Laxmi Shrikhande
Dr .Alok Vashistha
ACKNOWLEDGEMENTS
All FOGSI Members
www.fogsi.org
23. Thank You for your kind attention
Institute of Infectious Diseases
Nirmal Medical Foundation, Hardwar
Institute of Infectious Diseases
Hinweis der Redaktion
{"12":"It is important to collect and record information about the exposure on an exposure report, and to maintain the confidentiality of both the worker and the source patient. An exposure report should include the date and time that the exposure occurred, as well as details of what procedure was being performed, where, how, and what device (if any) was involved. If a device was involved, OSHA requires that the brand and manufacturer of the device be recorded. Details such as the route of exposure, body substance involved, and volume or duration of contact also should be included. Additionally, information about the source person and exposed person, if known, is critical, along with exposure management details, which will be discussed later.\n"}