Universal Work Precautions and Post-exposure Prophylaxis (PEP) for HIV following Needle Stick Injury

2009 ◽  
pp. 336-336
Author(s):  
Alok Vashishtha ◽  
BB Rewari
Keyword(s):  
Needle Stick Injury ◽  
Post Exposure Prophylaxis ◽  
Needle Stick ◽  
Post Exposure ◽  
Exposure Prophylaxis

scholarly journals Prevalence of Needle Stick Injury among Surgeons

2021 ◽  
pp. 89-94
Author(s):  
Nasima Iqbal ◽  
Faiza Quraishi ◽  
Muhammad Aslam Bhatti ◽  
Faizah Mughal ◽  
Tayyaba Mumtaz ◽  
...  
Keyword(s):  
Reporting System ◽  
Medical Center ◽  
Working Hours ◽  
Work Load ◽  
Needle Stick Injury ◽  
Post Exposure Prophylaxis ◽  
Cross Sectional ◽  
Needle Stick ◽  
Post Exposure ◽  
Exposure Prophylaxis

Aim: To find out the prevalence of needle stick injury, its reporting system and the reasons behind it. Study design: Descriptive cross-sectional Place and duration of study: Study was conducted at Jinnah post-graduate medical center (JPMC) Karachi during the period of March to September 2019 Methodology: A self-designed, self-explanatory questionnaire was used, consisting of two parts, the first part was about demographic information while second part is for information related to needle stick injury like probable cause, frequency, response after injury, post-exposure prophylaxis and about reporting of the incident. Questionnaire was validated by calculating the Cronbach’s alpha which was 0.78. data was analyzed by using the Statistical Package for the Social Sciences (SPSS) version 20. Results: Majority of the study participants were female (67.2%) and about 50% were postgraduate students. Out of total 134 doctors about 64.2% of the doctors had needle stick injury during their career. Finding out the most probable cause of needle stick injury during the survey it was found out that increased work load and prolonged working hours were the main reasons. Majority of the cases occurred in emergency department (41.9%). About 95.5% of the doctors didn’t get any post-exposure prophylaxis. Majority of the participants (96.3%) did not report to any authority because of the lack of knowledge about the reporting policy, it was noted that about 38.8% were confused either the reporting system exist or not. Most of the injuries occur during the procedure of suturing followed by recapping syringes. Conclusion: It has been concluded that majority of the doctors had faced needle stick injury during their career and a very negligible number of them got any post-exposure prophylaxis. Majority of them did not report to any authority. So there is a need of implication of safety measures and reporting policies for early detection and treatment of infections after needle stick injury.

scholarly journals Post exposure prophylaxis for HIV among healthcare workers due to occupational exposure: a record based study at a tertiary care teaching hospital of Kolkata

2021 ◽  
Vol 8 (5) ◽  
pp. 2503
Author(s):  
Paramita Sarkar ◽  
Saibendu Kumar Lahiri
Keyword(s):  
Occupational Exposure ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Occupational Exposures ◽  
Post Exposure Prophylaxis ◽  
Care Hospital ◽  
Skin Mucus ◽  
Needle Stick ◽  
Post Exposure ◽  
Exposure Prophylaxis

Background: Healthcare workers (HCWs) regularly face the risk of exposure to sharp injuries and splashes as an occupational hazard, which presents major risk for acquiring blood-borne infectious agents like human immunodeficiency virus (HIV) which can be minimized by taking post exposure prophylaxis (PEP) measures. There are limited studies from India documenting details of PEP for HIV. This record-based study aimed to determine the occurrence of needle stick injuries (NSIs) and other high-risk occupational exposures to blood and body fluids (BBFs) among HCWs in a tertiary care hospital, Kolkata. We aimed to study details of PEP regimens used among HCWs exposed to HIV.Methods: Hospital record was analyzed from reported incidences of occupational exposures to BBFs occurred during the period of October 2013 to March 2019. Information on self-reported incidence of occupational exposure, and post-exposure management were collected.Results: A total of 105 incidents of occupational exposure were registered during study period. Interns (37, 35.2%) were most frequently exposed, followed by physicians (22, 21.0%) and nurse (21, 20.0%). 88 (83.8%) of the personnel sustained NSIs, and 17 (7.2%) had splashes to skin, mucus membranes. There was no significant difference between subjects with splashes to skin, mucus membranes and needle-stick cases regarding discontinuation of post exposure prophylaxis (PEP) (11.8% versus 19.3%, p<0.548). No cases of sero-conversion were reported.Conclusions: In spite of high incidences of exposures to HIV source, good efficacy of PEP was observed with no sero-conversion. PEP for HIV was well tolerated. Study emphasized the need for creating awareness about timely reporting of incidence.

scholarly journals Cutaneous manifestations of anti retroviral therapy used for post-exposure prophylaxis

2018 ◽  
Vol 7 (10) ◽  
pp. 2057
Author(s):  
Chinmay T. Jani ◽  
Supriya D. Malhotra ◽  
Pankaj R. Patel
Keyword(s):  
Health Care ◽  
Reverse Transcriptase ◽  
Health Care Workers ◽  
Fixed Dose ◽  
Post Exposure Prophylaxis ◽  
Cutaneous Manifestations ◽  
Needle Stick ◽  
Post Exposure ◽  
Care Workers ◽  
Exposure Prophylaxis

Health care workers are at increased risk of needle stick injuries. Blood borne diseases that could be transmitted by such an injury include HIV, Hepatitis B, HCV and many others. Post exposure prophylaxis should be immediately started within 72 hours and should be continued for 28 days. Currently two Nucleoside Reverse Transcriptase Inhibitors (NRTIs) are given along with one NNRTI (Non- Nucleoside reverse Transcriptase Inhibitor) including Efavirenz or Nevirapine. Multiple adverse effects have been reported with all the Anti- Retroviral Therapies including various cutaneous manifestations. A 22-year-old intern doctor studying in tertiary hospital of Ahmedabad had a needle stick injury with a needle contaminated with blood of HIV positive patient. Post Exposure prophylaxis was started within 72 hours consisting of fixed dose regimen of Tenofovir disprodoxil sulphate, Efavirenz and lamivudine. He was started with the drug within 2 hours and was prescribed one drug per day for next 27 days. On 22nd day he started having rash on his body which started on palms and soles. On 23rd day he saw severe facial edema along with edema on lips and rash spreading to other parts of the body. He was diagnosed with Hypersensitivity reaction and angioedema due to ART drug therapy. He was instructed to stop ART medications and was given antihistaminic for the symptoms. Patient's angioedema was relieved in 2-3 days and rash disappeared after 4-5 days. As he had already finished 23 days of therapy he was instructed to discontinue the drugs. No recurrence of rash or angioedema was noted. This case points out the severity of side effects in the normal healthy people taking ART as Post Exposure Prophylaxis. Apart from cutaneous manifestations, angioedema is a very grievous condition which doctors should always have lower threshold for diagnosis. Early diagnosis can prevent further complications. ART drugs have many complications and these patients should have intensive regular monitoring while on treatment. Also, proper education is required for needle cut injuries in health care workers.

Post-Exposure Prophylaxis

2019 ◽  
Author(s):  
C. Y. William Tong
Keyword(s):  
Risk Assessment ◽  
Hepatitis B ◽  
Severity Of Illness ◽  
Unknown Origin ◽  
Needle Stick Injury ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Stray Dog ◽  
Mode Of Transmission ◽  
Exposure Prophylaxis

Post-exposure prophylaxis (PEP) is a treatment administered to an individual to prevent the development of infection or reduce the severity of illness after a potential or documented exposure to a microorganism. This may primarily be for the protection of the exposed individual concern, or in the case of a pregnant woman, for protecting the foetus in utero. PEP may also be useful in public health to reduce the risk of secondary spread of infection. A good history is required in order to make a proper assessment of the risk. The following questions should be asked: A. Which infection is suspected and is the source infectious? It is straight forward if the diagnosis of the source of exposure is already known, e.g. known HIV, established diagnosis of tuberculosis. However, in many cases, the diagnosis of the source may not be certain, e.g. needle stick injury involving a needle of unknown origin, bitten by a stray dog, exposed to a child with a non-specific rash. In such cases, a risk assessment is required to assess the likelihood that the source may be infectious. Knowledge of local epidemiology or recent outbreaks in a particular locality may help in such risk assessment. B. What is the nature of the exposure? Knowledge of the mode of transmission of a microorganism is important to establish if there is any risk of transmission through the exposure In the case of mother-to-child transmission, PEP to the neonate born to a mother with an infection is effective if the mode of transmission is predominately perinatal, e.g. hepatitis B. If the mode of transmission is transplacental, it is too late to administer PEP to the baby after delivery. Instead, the expected mother should be given prophylaxis during pregnancy to prevent infection, e.g. chicken pox, or given antivirals to reduce infectivity, e.g. maternal hepatitis B with a high viral load when transplacental infection may occur. In HIV, where transmission can occur both transplacentally and perinatally, antiretroviral therapy (ART) needs to be given during pregnancy and often during labour as well as to the baby after birth.

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