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Inoculation or Contamination Incidents Sharps, Bites, Scratches, or Cuts Following incident, assess the risk of transmission of blood borne viruses e.g. HIV, Hepatitis B, Hepatitis C (see guidance at foot of page) Immediate Action / First Aid Infection may be transmitted from infected patients/clients to staff members, through inoculation, or contamination by blood or body fluids. Is source/patient known/highly suspected to be HIV Positive? YES This can happen in many ways, examples may be: NO Follow route below Follow route below Puncture wounds from (e.g. needlestick, scratch or bite with skin break) Cuts from dirty instruments or razors, Are you Community staff Are you hospital staff? Contamination from splashes of blood/ body fluids onto open skin lesions, conjunctivae or mucous membranes of eye/nose/mouth YES Inform your line manager who will immediately contact the nearest Accident & Emergency Department, and tell them that a staff member will be arriving following exposure to HIV Accidental exposure to blood or body fluid: First Aid to be followed:Action for Sharps injury/splash/puncture wounds from needles, scratches or bites 1. Bleed it: Encourage bleeding -but do not massage the site. If puncture wound, do not suck it. Contact the Occupational Health Department immediately for help with Risk Assessment & advice about treatment. Where possible staff member to contact Accident & Emergency informing them of the incident and that they will be arriving following exposure to HIV. Telephone 023 8047 5236 or 07775 800333 * When Occupational Health closed go to A & E Department 2. Wash it: Your local Accident & Emergency Department is: Wash the wound / exposed area with soap and hot running water Information needed: Patient's name or origin of source, DOB, address, GP/Consultant, diagnosis and treatment if known Irrigate eyes with water use sterile water if you have it. (If contact lenses are worn, irrigate eyes, remove lenses and irrigate eyes again.) ..................................................... ..................................................... 3. Report it: Report incident immediately to Occupational Health and Safety Service or Accident and Emergency Dept as in flow chart If staff member has no transport they should go to A & E, by taxi. (The Trust will reimburse the fare). All staff should report the Incident to their Line Manager as soon as possible and ensure an Incident form is completed. Accident & Emergency Department Following a full risk assessment, advice and treatment will be offered. If source/patient was HIV positive Antiretroviral Therapy may be offered, (ideally within one hour of incident). Staff who attend A & E, should inform Occupational Health the next working day to discuss possible follow up treatment. If source/patient is HIV/Hepatitis B/Hepatitis C positive, Incident form must be reported under RIDDOR. Information To Guide The Assessment of Risk of Blood Borne Viruses (BBV) Relevant information to consider: 1 Is the source patient/client known or unknown? 2 If unknown, is there any indication of the origin of device or body fluids? (For example was the device from a ward with patients known to have hepatitis B or C or HIV?) 3 If known, is the source patient/client known to be infected with hepatitis B, hepatitis C or HIV? (The validity of results varies depending on how long ago they were measured and current risk factors.) 4 If the source patient/client is NOT Known to carry any of these infections, do they have any risk factors for them? See Below: HIV Hepatitis B Hepatitis C The following may indicate that the (source) patient/client a higher risk of HIV The following may indicate a higher risk of Hepatitis B The following may indicate a higher risk of Hepatitis C Individuals who have been living in an area of the world with a high prevalence of HIV e.g. Africa (South/East/Central Africa). The source patient/client is known to be or highly suspected to be infected with hepatitis B. The source patient/client is known to be or highly suspected to be infected with Hep C. Intravenous drug users. Received unscreened blood or untreated plasma products, in the UK prior to September 1991(blood) and 1985 (plasma products) or has received blood /plasma products from country where blood is not tested for hepatitis C virus. Individuals who may be at risk of HIV through unsafe sexual activity e.g. unprotected vaginal or anal intercourse, unprotected sex with HIV positive partner or partner who puts themselves at risk because of their sexual behaviour. Intravenous drug users. Blood transfusion before Oct 1985. Mother HIV positive. Individuals who may be at risk of hepatitis B through unsafe sexual activity (e.g. unprotected vaginal or anal intercourse) Unprotected sex with hepatitis B positive partner or partner who puts themselves at risk because of their sexual behaviour; People with hepatitis B infected mothers. People from Africa and Middle / Far East Blood transfusion abroad. Reference: www.hpa.org.uk/infectionsaz/bbv www.riddor.gov.uk www.needlestickforum.net www.nhsemployers.org/EmploymentPractice/occupational_health_guidance.asp Shared equipment whilst misusing drugs. Source has worked as a health care worker or has been a patient in invasive medical, surgical, dental or midwifery procedures in parts of the world where infection control procedures may have been inadequate, or with populations with a prevalence of hepatitis C infection (eg Egypt)