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Exposure to Blood and Body Fluids

Emergency Department Guide to Mandatory Blood Testing Act Feb 2008 (113 kb) Form 1 - Physicians Report Form 2 - Applicant Report Form 3 - Respondent Form

The Leeds, Grenville and Lanark District Health Unit developed Guidelines for Managing Exposures to Blood Borne Pathogens - These guidelines are to support health care providers in their assessment and management of persons with accidental exposures to blood and body fluids that may be infected with hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The guidelines address both occupational and non-occupational exposures.

All persons with significant recent exposures to blood or body fluids should be immediately referred to the nearest emergency department.

The Health Unit is currently revising this document and an updated version will be available soon.

Full Document: (bookmarked/indexed)
Guidelines for Managing Exposures to Blood Borne Pathogens (125 kb PDF )

Table of Contents

Introduction - Page 1

Exposure to Blood/Body Fluids - Page 2

A. Initial Management Guidelines

I. General Measures - Page 2

II. Evaluate the Significance of the Exposure - Page 2

III. Serologic Testing for HBV, HCV and HIV - Page 4

• Test the Source Patient
• Mandatory Blood Testing Act, 2006 Chapter 26
• Test the Exposed Person

B. Post Exposure Management: Human Immunodeficiency Virus (HIV)

I. Risk of HIV Infection Post Exposure - Page 6

II. The Importance of Timing - Page 6

III. Medication Availability and Cost (Antiretrovials) - Page 6

IV. Serologic Testing (if antiretrovirals are indicated) - Page 7

C. Post Exposure Management: Hepatitis B Virus (HBV)                 

I. Risk of HBV Infection Post Exposure - Page 9

II. Post Exposure Prophylaxis for HBV - Page 9

D. Post Exposure Management: Hepatitis C Virus (HCV)

I. Risk of HCV Infection Post Exposure - Page 9

II. Post Exposure Prophylaxis for HCV/Early Treatment for HCV - Page 9

E. Post Exposure Counseling                                                                          

I. Risk of Infection Post Exposure - Page 11

II. Reporting Illness in the Follow-up Period - Page 11

III. Secondary Spread - Page 11

IV. Medication (PEP) Compliance and Medical Follow-up - Page 11

Managing Non-Occupational Exposures to Blood/Body Fluids

F. Community Acquired Needle Stick Injuries

I. Decisions Surrounding Community Exposures - Page 13

II. Infectious Risks - Page 13

III. Counseling Recommendations and Follow-up - Page 14

G. Sexual Exposures

I. The Risk of Transmission following a Sexual Assault - Page 15

II. Evidence to Support HIV Post Exposure Prophylaxis - Page 15

III. Treatment - Page 15

H. Human Bites

I. Significance of the Exposure - Page 16

II. Management of Human Bites - Page 17

I. Important Contact Information - Page 17

J. Bibliography - Page 18