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How to deal with an exposure incident

This section of the guidance is aimed at helping those involved in the initial management of the incident, to determine whether onward referral to such professional advice is necessary. The term 'source' means the person/item from which the blood or body fluid originated, whilst the term 'recipient' means the person exposed to potentially BBV infected blood or body fluids.

Employees

What should I do?

Employers

Employers are legally required to undertake emergency planning as part of their employer responsibilities.

Sources of authoritative guidance

Authoritative information sources related to BBV post exposure intervention and treatment:

Immediate first aid requirements

It is not necessary to keep any needle/sharp instrument to send to the laboratory for testing for the presence of blood-borne viruses. Any such sharp instruments should not be re-sheathed, but disposed of directly into an appropriate container.

Incident evaluation

An urgent risk assessment is required to establish if the exposure has the potential to transmit a blood-borne virus – ie, whether or not the exposure is significant. A number of factors will be taken into account in the risk assessment, including:

All of the above will contribute to decisions on whether HIV and/or HBV post-exposure prophylaxis (PEP), or follow-up for evidence of HCV transmission, is required.

Risk of transmission of blood borne viruses from patient to health care worker

Infection Patient to health care worker Intervention
Hepatitis B Up to 30%** Post-exposure prophylaxis with vaccine and/or HBIg
Hepatitis C 1-3% Monitor recipient.  Early therapy if transmission occurs
HIV 0.3% Post-exposure prophylaxis – anti-retroviral drugs

**There is a wide variability in infectiousness of hepatitis B carriers.  The risk stated is that of transmission following needlestick exposure in unvaccinated individuals.

Updated 2015-06-30