Download Source Known Source Source Known Source Known Source Known

Health Care Provider (HCP) Occupational Exposure
Standard Care


Wash Wound
Flush mucous membranes
Hepatitis B Virus Pathway




HCP contacts infection control
officer at receiving hospital &/or
follow department procedures
Confirmed exposure incident? (1)
YES
NO
Case by Case Basis
NO
Source Known?
No Post Exposure Prophylaxis
(PEP)
Unknown source
or unable to
override consent



YES
Source
Known
HIV Positive?
NO
YES
Source
Known
Source Known
HCP HPV Vaccination History
Follow HBV Guidelines for
PEP (Table 1)
Exposure Type
Risk in Population
Risk/Benefit of PEP
Case by Case Basis
NO
Exposure < 72 hours?



Source YES
Known
Exposure Type
Risk in Population
Risk/Benefit of PEP
Exposure Type
Source Known
Mucous or Non-intact Skin
Percutaneous
Source Known
Source Known
Severe Exposure:
Small Volume Exposure
(Few drops) (1)
Large Volume Exposure
(Major blood splash) (1)
Source Known
Source Known
Class I
Class II
Consider Basic 2-Drug PEP
Class I
Class II



Deep puncture
Large hollow bore needle
Visible blood on device

Needle used in patient artery or vein
Class I
Class II
Basic 2-Drug PEP
Less Severe Exposure:


Solid needle
Superficial injury
Class I
Class II
Basic 2-Drug PEP
Expanded 3-Drug PEP
Expanded 3-Drug PEP
Class I: asymptomatic HIV or viral load <1500 copies/mL
Class II: symptomatic, AIDS, acute seroconversion, high viral load
Basic 2-Drug PEP:
Expanded 3-Drug PEP:


Per U.S. Public Health Service Guidelines (1)
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm


Per U.S. Public Health Service Guidelines (1)
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm
Generally No PEP/Case by Case Basis: Generally no PEP warranted for Unknown Source Cases or Exposure >72 hours, but may consider Basic
PEP based on Source Risk Factors: rape, sex for money, IV drug abuse, or men having sex with men.
(1)
= Questions on Type of Exposure and/or Drug Therapy call National Clinicians Post-Exposure Prophylaxis Hotline = 1-888-448-4911