If you are exposed to the blood of a patient, the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention* recommends the following:

1. Immediately following an exposure to blood:

"Wash needle sticks and cuts with soap and water

Flush splashes to the nose, mouth, or skin with water

Irrigate eyes with clean water, saline, or sterile irrigants"*

2. Immediately inform your supervising resident or attending physician. "Prompt reporting is essential because, in some cases, post exposure treatment may be recommended and it should be started as soon as possible."* Regarding HBV, HCV and HIV, “If the source individual cannot be identified or tested, decisions regarding follow-up should be based on the exposure risk and whether the source is likely to be a person who is infected with a blood borne pathogen.” It is recommended that if treatment is deemed necessary, it “should be started promptly, preferably within hours as opposed to days, after the exposure.”*

3. Go to the Emergency Department at whatever hospital you are at, or, if at a community setting, to the Occupational Medicine Office at Stony Brook Medical Park on Route 347/Nesconset Highway, next to Burger King. After business hours, go to the Stony Brook Emergency Department. “Post exposure treatment is not recommended for all occupational exposures to HIV because most exposures do not lead to HIV infection and because the drugs used to prevent infection may have serious sides effects. Taking these drugs for exposures that pose a lower risk for infection may not be worth the risk of the side effects. You should discuss the risks and side effects with a health-care provider before starting post exposure treatment for HIV. “*

If you are treated, the ER you are at may only give you a one or two day supply, but you can get the rest of the medications at Occupational Medicine in Stony Brook.

Once you have reported the needle stick and received initial management, you may report any needle stick incident to the Office of Medical Education for assistance.

4. "Discuss the possible risks of acquiring HBV, HCV, and HIV and the need for post exposure treatment with the provider managing your exposure. You should have already received Hepatitis B vaccine, which is extremely safe and effective in preventing HBV infection.” * 

5. “What specific drugs are recommended for post exposure treatment?

HBV

If you have not been vaccinated, then hepatitis B vaccination is recommended

for any exposure regardless of the source person’s hepatitis B

status. HBIG and/or hepatitis B vaccine may be recommended depending

on your immunity to hepatitis B and the source person’s infection status.

HCV

Currently there is no recommended post exposure treatment that will

prevent HCV infection.

HIV

Prophylaxis has been utilized to decrease the risk of development of HIV infection. The risk of transmission of HIV per episode of percutaneous exposure to HIV infected blood is on the average, approximately 0.3%.

The Public Health Service recommends a 4-week course of two drugs (zidovudine and lamivudine) for most HIV exposures, or zidovudine and lamivudine plus a protease inhibitor (indinavir or nelfinavir) for exposures that may pose a greater risk for transmitting HIV (such as those involving a larger volume of blood with a larger amount of HIV or a

concern about drug-resistant HIV). Differences in side effects associated with the use of these two drugs may influence which drug is selected in a specific situation.

6. “What precautions should be taken during the follow-up period?

HBV

If you are exposed to HBV and receive post exposure treatment, it is unlikely that you will become infected and pass the infection on to others. No precautions are recommended.

HCV

Because the risk of becoming infected and passing the infection on to others after an exposure to HCV is low, no precautions are recommended.

HIV

During the follow-up period, especially the first 6-12 weeks when most infected persons are expected to show signs of infection, you should follow recommendations for preventing transmission of HIV. These include not donating blood, semen, or organs and not having sexual intercourse, If you choose to have sexual intercourse, using a condom consistently and correctly may reduce the risk of HIV transmission. In addition, women should consider not breast-feeding infants during the follow-up period to prevent exposing their infants to HIV in breast milk.