[MCOH-EH] MCOH-EH Digest, Vol 250, Issue 29
Jeff Jacobs, MD
JacobJef at einstein.edu
Wed Feb 11 09:46:56 PST 2015
Steve:
In addition to the UCSF PEPline being a great resource, they also have a compendium of HIV testing by state. I pulled up this link for IN.
http://nccc.ucsf.edu/wp-content/uploads/2014/02/Indiana_Clinicians_HIV_Testing_Law_Reference.pdf
Jeffrey A Jacobs, MD, MPH
Medical Director
Einstein LiveWell EHS
1303 Tabor Rd
Philadelphia, PA 19141
215-456-1084
FAX: 215-456-1840>>> <mcoh-eh-request at mylist.net> 2/11/2015 12:28 PM >>>
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Today's Topics:
1. Needlestick/Blood and body fluid exposure Evaluations
(Wintermeyer, Stephen F.)
2. Re: Needlestick/Blood and body fluid exposure Evaluations
(Morelli, Karen J)
3. Re: Needlestick/Blood and body fluid exposure Evaluations
(Hudson, T. Warner)
4. Re: Needlestick/Blood and body fluid exposure Evaluations
(Subin, Kenneth MD)
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Message: 1
Date: Wed, 11 Feb 2015 15:20:13 +0000
From: "Wintermeyer, Stephen F." <swinterm at iu.edu>
To: "mcoh-eh at mylist.net" <mcoh-eh at mylist.net>
Subject: [MCOH-EH] Needlestick/Blood and body fluid exposure
Evaluations
Message-ID:
<379502AD64B494449FD4252C96ABCE832DFAB328 at IU-MSSG-MBX108.ads.iu.edu>
Content-Type: text/plain; charset="us-ascii"
I am reviewing our policy for the management of a needlestick or blood body fluid evaluation.
My understanding is the standard of practice in 2015 is to test a source patient with a Rapid HIV test, HepBsAg and HepCAb tests.
My question for the group is what is the standard of practice of management of the exposed individual. Obviously, counseling about risks and proper needle handling should be performed.
Do you require that the exposed individual come into the Employee Health clinic for face to face counseling or do you handle that by phone?
Do you test the exposed individual for HIV, HepBsAb and HepC for any exposure, or only if there is a specific reason to do so (such as the source patient is HIV +)?
Stephen Wintermeyer, MD, MPH
Director
Associate Professor of Clinical Medicine
Campus Health
Indiana University-Purdue University Indianapolis
Coleman Hall, Suite 100
1140 West Michigan Street
Indianapolis, IN 46202
317-274-8214
[IUPUI_ACR.H]
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Message: 2
Date: Wed, 11 Feb 2015 17:04:52 +0000
From: "Morelli, Karen J" <kmorelli at emhs.org>
To: 'MCOH/EH' <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Needlestick/Blood and body fluid exposure
Evaluations
Message-ID:
<8B8E7138F933B54BA8DBB3AEF14A5F1AA10D02C2 at MARINA.me.emh.org>
Content-Type: text/plain; charset="us-ascii"
The source patient is evaluated as you mentioned. The Healthcare Worker comes to Employee Health for evaluation/counseling-- or the Nursing Supervisor /ED if after hours. Hep B Surface Antibody (if we don't already know it is positive), HCV and HIV (not rapid) are ordered on all exposures so we know what the HCW's baseline is at the time of exposure.
Thank you,
Karen Morelli RN, BSN
Employee Health and Occupational Medicine
Eastern Maine Healthcare Systems
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Wintermeyer, Stephen F.
Sent: Wednesday, February 11, 2015 10:20 AM
To: mcoh-eh at mylist.net
Subject: [MCOH-EH] Needlestick/Blood and body fluid exposure Evaluations
I am reviewing our policy for the management of a needlestick or blood body fluid evaluation.
My understanding is the standard of practice in 2015 is to test a source patient with a Rapid HIV test, HepBsAg and HepCAb tests.
My question for the group is what is the standard of practice of management of the exposed individual. Obviously, counseling about risks and proper needle handling should be performed.
Do you require that the exposed individual come into the Employee Health clinic for face to face counseling or do you handle that by phone?
Do you test the exposed individual for HIV, HepBsAb and HepC for any exposure, or only if there is a specific reason to do so (such as the source patient is HIV +)?
Stephen Wintermeyer, MD, MPH
Director
Associate Professor of Clinical Medicine
Campus Health
Indiana University-Purdue University Indianapolis
Coleman Hall, Suite 100
1140 West Michigan Street
Indianapolis, IN 46202
317-274-8214
[IUPUI_ACR.H]
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Message: 3
Date: Wed, 11 Feb 2015 17:06:13 +0000
From: "Hudson, T. Warner" <TWHudson at mednet.ucla.edu>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Needlestick/Blood and body fluid exposure
Evaluations
Message-ID: <914D942A-EEB5-4C25-AFB1-5BF637AD827B at mednet.ucla.edu>
Content-Type: text/plain; charset="us-ascii"
At UCLA we do require face to face at OH or if not open our EDs and then OB follow up next day. Tests you described; clarify we do source rapid HIV 1 and exposed employee non rapid HIV 1+2. However we will change to 4th gen HIV testing this yr. TW Hudson MD
Sent from my iPhone
On Feb 11, 2015, at 8:50 AM, Wintermeyer, Stephen F. <swinterm at iu.edu<mailto:swinterm at iu.edu>> wrote:
I am reviewing our policy for the management of a needlestick or blood body fluid evaluation.
My understanding is the standard of practice in 2015 is to test a source patient with a Rapid HIV test, HepBsAg and HepCAb tests.
My question for the group is what is the standard of practice of management of the exposed individual. Obviously, counseling about risks and proper needle handling should be performed.
Do you require that the exposed individual come into the Employee Health clinic for face to face counseling or do you handle that by phone?
Do you test the exposed individual for HIV, HepBsAb and HepC for any exposure, or only if there is a specific reason to do so (such as the source patient is HIV +)?
Stephen Wintermeyer, MD, MPH
Director
Associate Professor of Clinical Medicine
Campus Health
Indiana University-Purdue University Indianapolis
Coleman Hall, Suite 100
1140 West Michigan Street
Indianapolis, IN 46202
317-274-8214
<image001.jpg>
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Message: 4
Date: Wed, 11 Feb 2015 12:27:19 -0500
From: "Subin, Kenneth MD" <ksubin at aomc.org>
To: <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Needlestick/Blood and body fluid exposure
Evaluations
Message-ID:
<80408DEC021F134D81B1D0689E6E6C72C0151C at AOMCEXCH1.arnot_nt.aomc.org>
Content-Type: text/plain; charset="us-ascii"
Attached are the guidelines we reference. I believe the PEP line
references these as well, unless there is something more updated that I
am not aware of.
Ken
Kenneth P. Subin, MD, MPH, CIME, CMRO
Clinical Medical Director
Occupational Medicine
ArnotHealth
Elmira, NY
(607) 737-4539 (p)
(607) 737-7783 (f)
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of
Wintermeyer, Stephen F.
Sent: Wednesday, February 11, 2015 10:20 AM
To: mcoh-eh at mylist.net
Subject: [MCOH-EH] Needlestick/Blood and body fluid exposure Evaluations
I am reviewing our policy for the management of a needlestick or blood
body fluid evaluation.
My understanding is the standard of practice in 2015 is to test a source
patient with a Rapid HIV test, HepBsAg and HepCAb tests.
My question for the group is what is the standard of practice of
management of the exposed individual. Obviously, counseling about risks
and proper needle handling should be performed.
Do you require that the exposed individual come into the Employee Health
clinic for face to face counseling or do you handle that by phone?
Do you test the exposed individual for HIV, HepBsAb and HepC for any
exposure, or only if there is a specific reason to do so (such as the
source patient is HIV +)?
Stephen Wintermeyer, MD, MPH
Director
Associate Professor of Clinical Medicine
Campus Health
Indiana University-Purdue University Indianapolis
Coleman Hall, Suite 100
1140 West Michigan Street
Indianapolis, IN 46202
317-274-8214
This message (including any attachments) is intended only for the use of the individual or entity to which it is addressed and may contain information that is non-public, proprietary, privileged, confidential, and exempt from disclosure under applicable law. If you are not the intended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, notify the sender immediately by telephone and delete this message
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Send administrative requests to: drjoe at meditrax.com
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