draft actions to take for exposure to bloodborne pathogens (hiv, hep c) do you still suspect source...
TRANSCRIPT
DRAFT
Actions to take for exposure to bloodborne pathogens (HIV, Hep C)
Actions to take for exposure to bloodborne pathogens (HIV, Hep C)
Do you still suspect
source HIV positive?
Do you still suspect
source HIV positive?
No /UNK
Submit additional blood sample from potential source to a laboratory for verification.
Blot a sample of Blood onto filter-paper and seal in plastic bag (See Blood Collection and Shipping Instructions)
Sample will travel with Soldier during EVAC to Germany and shipped via FedEx using account or be shipped DHL to WRAIR
Submit additional blood sample from potential source to a laboratory for verification.
Blot a sample of Blood onto filter-paper and seal in plastic bag (See Blood Collection and Shipping Instructions)
Sample will travel with Soldier during EVAC to Germany and shipped via FedEx using account or be shipped DHL to WRAIR
No
Yes
No
No
Yes
Educate Soldier and unit on Risk Factors and
Avoidance
Educate Soldier and unit on Risk Factors and
Avoidance
EXPOSURES with increased risk:Needle Stick, Contact with infected or suspected person's fluids, ORcontact with assailant body fluid via mucous membrane, non-intact skin or bite; OR unknown exposure (e.g, drug assisted) [AFRICA is considered High Risk]
EXPOSURES with increased risk:Needle Stick, Contact with infected or suspected person's fluids, ORcontact with assailant body fluid via mucous membrane, non-intact skin or bite; OR unknown exposure (e.g, drug assisted) [AFRICA is considered High Risk]
NO RISK EXPOSURES:Exposures where skin remains intact where there is no anal, vaginal, or oral penetration; no contact with source body fluids via mucous membrane,
NO RISK EXPOSURES:Exposures where skin remains intact where there is no anal, vaginal, or oral penetration; no contact with source body fluids via mucous membrane,
Conduct RDT (Rapid Diagnostic Test) on Source: 1 each, HIV, Hep B, Hep C
[do not use saliva, use blood]
Conduct RDT (Rapid Diagnostic Test) on Source: 1 each, HIV, Hep B, Hep C
[do not use saliva, use blood]
Is Source RDT
Positive?
Is Source RDT
Positive?
Yes
Yes HIV
IMMEDIATELY:•Begin Soldier Treatment PEP:Delay of PEP administration greater than 48 hours significantly diminishes efficacy of treatment regime.
•Begin Coordinating for EVAC to Landstuhl: Due to limited PEP supply on hand, evacuation should be completed within 72 hours.
IMMEDIATELY:•Begin Soldier Treatment PEP:Delay of PEP administration greater than 48 hours significantly diminishes efficacy of treatment regime.
•Begin Coordinating for EVAC to Landstuhl: Due to limited PEP supply on hand, evacuation should be completed within 72 hours.
Use Triple Drug Therapy, currently the best combination:•Dolutegravir x 1 tab per day, plus•Truvada (two drug combo) X1 Tab per day•Pre-treat w/Zofran or Phenergan to offset nausea/vomiting from meds
Use Triple Drug Therapy, currently the best combination:•Dolutegravir x 1 tab per day, plus•Truvada (two drug combo) X1 Tab per day•Pre-treat w/Zofran or Phenergan to offset nausea/vomiting from meds
Points of Contact:-LTC Lynch, SOCAF Surgeon (all MEDEVACs)DSN: 314-421-3339 COMM: +49 (0)711-729-3339SVOIP: (80) 304-436-2035NIPR: [email protected]: [email protected]•SOCAFRICA JOC: - DSN 421-3340/3370; 0711-729-3340/3370 - RED: 304-436-2100 - [email protected]•[email protected]•[email protected]•AFRICOM ID consultant
Points of Contact:-LTC Lynch, SOCAF Surgeon (all MEDEVACs)DSN: 314-421-3339 COMM: +49 (0)711-729-3339SVOIP: (80) 304-436-2035NIPR: [email protected]: [email protected]•SOCAFRICA JOC: - DSN 421-3340/3370; 0711-729-3340/3370 - RED: 304-436-2100 - [email protected]•[email protected]•[email protected]•AFRICOM ID consultant
HIV Post Exposure Prophylaxis Regimen
Note: Continued Treatment and consultation required, Testing will be required at 1, 3, 6 and 12 months
Note: Continued Treatment and consultation required, Testing will be required at 1, 3, 6 and 12 months
Is Contact Source
HIV Negative?
Is Contact Source
HIV Negative?
Is Source available for RDT (Rapid
Diagnostic Test)?
Is Source available for RDT (Rapid
Diagnostic Test)?
HIV PEP Kit Contents• Sealable rugged container: Otter/Pelican approx 5W"x7W"x3D"
– Labeled on Outside,• HIV Exposure Kit• Kit Contents with pertinent expiration date• Last inspection date and initials
• Drugs (should medics fill separate in case of expiration date?– Dolutegravir– Truvada
• Rapid Test - HIV RDT, (verify no special handling instructions or expiration)– Include extra lancet for blood sample– Ensure each kit has pipette if applicable (some RDTs have pipets separate)
• SOP/Flow Chart/shipping instructions - 5x7 laminated printout• Blood Sample Kit
– FTA Micro Card (x2)– alcohol wipe – sterile lancet – adhesive bandage– gloves, – Multi-Barrier Pouch (strong ziplock to hold the blood sample)– mailing envelope– tamper-proof tape for the mailing envelope, – Desiccant– clear outer bag (labeled with code number and expiration date
• Gloves• Pre-Printed labels• Desicant bag - keep moisture out
Blood Sample Kit• Blood Sample Collection Instructions 5x7 laminated• FTA Micro Card (x2)• alcohol wipe • sterile lancet • adhesive bandage• gloves, • Multi-Barrier Pouch (strong ziplock to hold the blood sample)• mailing envelope• tamper-proof tape for the mailing envelope, • Desiccant• clear outer bag (labeled with code number and expiration date
Actions to take for exposure to bloodborne pathogens (HIV, Hep C)
Actions to take for exposure to bloodborne pathogens (HIV, Hep C)
Is Contact Source HIV Negative?
Is Contact Source HIV Negative?
Conduct RDT on Source
Conduct RDT on Source
Is Source RDT
Positive?
Is Source RDT
Positive?
Do you still suspect
source HIV positive?
Do you still suspect
source HIV positive?
No /UNK Is Source available for RDT?
Is Source available for RDT?
Always submit additional blood sample from the potential source to a laboratory for verification. Blot a sample of Blood onto filter-paper and seal in plastic bagSample will travel with Soldier during EVAC and turned into lab
Always submit additional blood sample from the potential source to a laboratory for verification. Blot a sample of Blood onto filter-paper and seal in plastic bagSample will travel with Soldier during EVAC and turned into lab
Yes
No
Yes
Yes
No
No
Yes
Educate Soldier and unit on Risk Factors and
Avoidance
Educate Soldier and unit on Risk Factors and
Avoidance
HIGH RISK EXPOSURES:Needle Stick, Contact with infected or suspected person's fluids, ORcontact with assailant body fluid via mucous membrane, non-intact skin or bite; OR unknown exposure (e.g,, drug assisted)[AFRICA]
HIGH RISK EXPOSURES:Needle Stick, Contact with infected or suspected person's fluids, ORcontact with assailant body fluid via mucous membrane, non-intact skin or bite; OR unknown exposure (e.g,, drug assisted)[AFRICA]
NO RISK EXPOSURES:No anal, vaginal, or oral penetration; No contact with assailant body fluid via mucous membrane, non-intact skinor bite Contact with fluids of non-infected person
NO RISK EXPOSURES:No anal, vaginal, or oral penetration; No contact with assailant body fluid via mucous membrane, non-intact skinor bite Contact with fluids of non-infected person
HIV
IMMEDIATELY:•Begin Soldier Treatment PEP:Delay of PEP administration greater than 48 hours significantly diminished efficacy of treatment regime.
•Begin Coordinating for EVAC to Landstuhl: Due to limited PEP supply on hand, evacuation should be completed within 72 hours.
IMMEDIATELY:•Begin Soldier Treatment PEP:Delay of PEP administration greater than 48 hours significantly diminished efficacy of treatment regime.
•Begin Coordinating for EVAC to Landstuhl: Due to limited PEP supply on hand, evacuation should be completed within 72 hours.
Use Triple Drug Therapy, currently the best combination:•Daltegravir x 1 tab per day, plus•Truvada (two drug combo) X1 Tab per day•Pre-treat w/Zofran or Phenergan to offset nausea/vomiting from meds
Use Triple Drug Therapy, currently the best combination:•Daltegravir x 1 tab per day, plus•Truvada (two drug combo) X1 Tab per day•Pre-treat w/Zofran or Phenergan to offset nausea/vomiting from meds
Points of Contact:-LTC Lynch, SOCAF Surgeon (all MEDEVACs) DSN: 314-421-3339COMM: +49 (0)711-729-3339SVOIP: (80) 304-436-2035NIPR: [email protected]: [email protected]
•[email protected]•AFRICOM ID consultant
Points of Contact:-LTC Lynch, SOCAF Surgeon (all MEDEVACs) DSN: 314-421-3339COMM: +49 (0)711-729-3339SVOIP: (80) 304-436-2035NIPR: [email protected]: [email protected]
•[email protected]•AFRICOM ID consultant
HIV Post Exposure Prophylaxis Regimen
Note: Continued Treatment and consultation required, Testing will be required at 1, 3, 6 and 12 months
Note: Continued Treatment and consultation required, Testing will be required at 1, 3, 6 and 12 months
