Exposure procedures for students on extramural electives
SIU SCHOOL OF MEDICINE MEDICAL STUDENTS AT AWAY ELECTIVES
WHAT TO DO IF AN EXPOSURE OCCURS
- Take the Exposure Infection Control Report document packet with you to your away elective.
- If an exposure occurs, wash the area with soap and water thoroughly. If a mucous membrane splash occurs, flush the area with water for several minutes.
- Notify your immediate supervisor in the area you are working. Then contact the individual responsible for infection control at that facility. You will be directed per the facility’s exposure protocol and should follow it unless they are unsure of how to manage a medical student exposure. If there is a question, refer to the information beginning with #5 of these directions.
- After you have been taken care of, the next call you make should be to the Infection Control Nurse at SIU SOM (217) 545-8970. It is imperative the infection control nurse be made aware of the exposure!!!!
- Make known the source patient labs that need to be drawn immediately – HIV Elisa, HBVSAg, HBV core Ab, HCVAb. This should be done under a confidential system. Patient name should not be used per OSHA regulations. However that will depend on the facility’s protocol.
- Make known the baseline labs that need to be drawn on you, the exposed individual, immediately – HIV Elisa, HBVAb, HCVAb. This should be done under a confidential system. Your name should not be used per OSHA regulations. For any questions, contact the infection control nurse in Springfield.
- Determine if the source patient is at risk of being HIV positive:
Does the source patient’s history, medical record indicate any of the following:
- Known HIV positive
- Known homosexual, bisexual, prostitute, or sexual contact with same
- Known IV drug user or history of same
- Received blood transfusion 1977-1985
- Currently taking Zidovudine (AZT), Lamiduvine (3TC), and/or Indinivir (IDV)
- History of hepatitis B, past, present, or carrier
- History of hepatitis C, past, present, or carrier
- History of hemophilia, kidney, dialysis, transplant
If there is any potential that the source patient could be HIV positive, you will need to take the following medications. Begin taking the medications within the first two hours following the exposure, for three days, or until the source patient’s lab results confirm that he/she is HIV negative:
Retrovir 100mg – 2 caps 3 times a day #18 (600mg total/day)
Epivir 150mg – 1 tab every 12 hours #6 (300mg total/day)
Crixivan 400mg – 2 caps 3 times a day #18 (2400mg total/day)
If the source patient’s lab results confirm HIV positive, you will need to take the above medications for 4 weeks.
As you can see from the information above, it is very important to contact the infection control nurse in Springfield so that the exposure is handled appropriately and quickly.
Regardless of how the various facilities manage the exposure, you will still need to complete the SIU SOM Exposure documents for inclusion in your health file at SIU SOM. You will also need to get copies of your labs and the source patient’s labs to include with the exposure documents.