TJ/C/0002/01: Annex:1 Reference Policy: Management of needle Stick injury and other potential exposures: By medical officer Reviewed date: 22/08/2013
Assess the exposed person according to following guideline
1. Type of exposure
• Percutaneous injury • Mucus membrane exposure
2. Type and amount of tissue /blood
• Other potentially infectious material – CSF, Pleural or pericardial fluid, Amniotic
fluid ,semen ,vaginal secretions, respiratory secretions
3. The following tests should be performed on source person (Patient) if known after obtaining the consent. The consent should be taken by the ward medical officer 4. Evaluation of exposed person (HCW). Consent should be taken when obtaining blood for testing
• Assess the Hep B /C status – H/O hepatitis B or C
• If all 3 doses of Hep B is taken and immune status is not known do Hep B antibody
5. Management for HIV exposure
• If the source person is negative for above infections baseline tests or follow up tests
are not necessary for the exposed person.
• If source person refuses testing consider the clinical diagnosis and history of risky
• If the source is unknown consider as high risk exposure
TJ/C/0002/01: Annex:1 Reference Policy: Management of needle Stick injury and other potential exposures: By medical officer Reviewed date: 22/08/2013 Exposure code (EC)
Is the source material blood, body fluid, other potentially infectious material (OPIM), or
an instrument contaminated with one of these substances
No PEP required
Type of exposure? Less Severe More severe(e.g. Small Volume Large Volume TJ/C/0002/01: Annex:1 Reference Policy: Management of needle Stick injury and other potential exposures: By medical officer Reviewed date: 22/08/2013 Source Code (SC) Determination of PEP Recommendation PEP Recommendation
Consider basic regimen (negligible risk)
Recommend basic regimen (most exposures are in this
If setting suggests a possible risk (epidemiological risk factors
and EC is 2 or 3, consider basic regimen)
TJ/C/0002/01: Annex:1 Reference Policy: Management of needle Stick injury and other potential exposures: By medical officer Reviewed date: 22/08/2013 6. Post exposure Prophylaxis (PEP) for HIV
• Basic regimen- Zidovudine- 200mg8 hrly /300mg 12 hrly • Lamivudine 150mg 12 hrly • Expanded regime- • Zidovudine - 200mg 8 hrly /300mg 12 hrly • Lamivudine -150mg 12 hrly •
Refer the exposed person to National STD/AIDS Control program for counseling. I
nitiate PEP as soon as possible (within few hou s of exposure).Continue for 4 weeks. Monitor
the HCW for evidence of drug toxicity. 7. Post exposure prophylaxis for HBV
Vaccination and Treatment antibody response status of exposed
Previously vaccinated Known responder Known non responder Antibody response Hepatitis B immunoglobulin dose is 0.06 ml/kg intramuscularly If exposed person gives a H/O Hep B infection – No post exposure prophylaxis is necessary TJ/C/0002/01: Annex:1 Reference Policy: Management of needle Stick injury and other potential exposures: By medical officer Reviewed date: 22/08/2013 8. Follow up testing
onths and 6 months /if an illness compatible with an
2) Advice regarding prevention of secondary transmission during the follow up period
Anti-Hep Bs for person received vaccination
8.4. The medical officer should fill the exposure report (Attachment II of Management of
needle stick/sharp injuries and other potential exposure policy)
Consideraciones teóricas acerca del trabajo metodológico en la educación primariaTheoretical Considerations Concerning the Methodological Work in Elementary Centro Universitario “Jesús Montané Oropesa” Resumen: Las exigencias actuales en la escuela primaria requieren perfeccionar cada vez más el trabajo metodológico, como vía fundamental para garantizar la calidad del proceso ed