Body Fluid Exposures Follow-up

  • Author: Nathalie Mathieu, MD; Chief Editor: Rick Kulkarni, MD   more...
 
Updated: Aug 25, 2010
 

Further Outpatient Care

If the source patient is positive for HBV, HCV, and/or HIV, repeatedly test the exposed caregiver at timed intervals of 0, 3 months, and 6 months. This requires close and reliable follow-up mechanisms, such as Occupational Health Services or primary care physicians.

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Deterrence/Prevention

OSHA standards are to be encouraged and reinforced by all hospital employees consistently because prevention is the single best weapon against blood/body fluid exposures.

The following universal precautions should be followed in all patient contact situations:

  • Wash hands between care of each patient.
  • Use gloves when handling body fluids or performing procedures where exposure is possible, including contact with mucous membranes.
  • Use protective gowns, eyewear, and masks during procedures when risk of splash or spray of body fluids exists.
  • Never recap needles. If recapping is necessary, the cap should not be held by hand, rather lay the cap on a firm surface and insert the needle. Then, the entire system is lifted, and the cap is secured in place.

OSHA requirements are now moving toward needleless and needlestick prevention systems as basic requirements in health care facilities. Institutions must evaluate these systems and utilize those that function best within their departments.

Wearing gloves may reduce (>50%) the volume of blood introduced through the injury.

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Complications

Infection is still a significant concern at any given exposure, especially those involving disruption of the normal integumentary barrier. Antibiotic prophylaxis should be considered.

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Prognosis

Prognosis is associated with risk of infection and its sequelae. This is difficult to specify in any given patient. However, given the risk of HIV transmission of less than 1%, the prognosis of any given exposed patient may be listed as good but may only remain so with vigilant follow-up and consistent use of prophylaxis against infection.

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Patient Education

For excellent patient education resources, visit eMedicine's Public Health Center and Sexually Transmitted Diseases Center. Also, see eMedicine's patient education articles Hepatitis B, Hepatitis C, and HIV/AIDS.

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Contributor Information and Disclosures
Author

Nathalie Mathieu, MD  Resident Physician, Department of Emergency Medicine, State University of New York Downstate Medical Center

Disclosure: Nothing to disclose.

Coauthor(s)

Joel R Gernsheimer, MD, FACEP  Visiting Associate Professor, Department of Emergency Medicine, Attending Physician and Director of Geriatric Emergency Medicine, State University of New York Downstate Medical Center

Joel R Gernsheimer, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Samuel M Keim, MD  Associate Professor, Department of Emergency Medicine, University of Arizona College of Medicine

Samuel M Keim, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Public Health Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Pharmacy Editor, eMedicine

Disclosure: Nothing to disclose.

Barry J Sheridan, DO  Chief, Department of Emergency Medical Services, Brooke Army Medical Center

Barry J Sheridan, DO is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD 

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

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Flowsheet for management of blood/body fluid exposures.
 
 
 
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