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Post Exposure Management 2009

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42 views35 pages

Post Exposure Management 2009

Uploaded by

breezemolecular.lab
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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8 Post Exposure Management (PEM) for HIV, Hepatitis B & C in Healthcare Settings

4. Post Test Counseling


• All HCPs who underwent baseline testing must be given a post
test counseling regardless of the result.
• If the test is positive, provide the HCP with an initial emotional
support. Make the necessary arrangement to refer the HCP to
appropriate organizations or institutions providing counseling
and support when needed.
• Before commencing PEP treatment, all issues regarding PEP
must be explained to the exposed person (risks involved,
follow-up testing, and window period)

5. Drug selection

• The decision to use a two- or three-drug combination should


be based on the magnitude of risk, medical history, and other
circumstances that may be affected by taking the prescribed
medicines. (e.g., person is pregnant or breastfeeding).
Whenever possible, expert advice must be sought when
deciding on which medicines to be given.
• The following medicines should not be prescribed to pregnant
women: efavirenz, didanosine and stavudine combination, and
Indinavir due to possible adverse effects on both the woman
and the child.
• Other drugs that are not recommended: abacavir, delavirdine,
zalcitabine, and nevirapine.
• Adverse reactions to drugs are the common reasons for
discontinuing the treatment. Drugs without any contraindications
may be prescribed to minimize the side effects.
• Refer to page 17 for a listing of ARVs, its recommended
dosages, advantages, and disadvantages.

6. Follow-up

• Exposed person should be encouraged to report any acute


illnesses during the follow-up period.
10 Post Exposure Management (PEM) for HIV, Hepatitis B & C in Healthcare Settings

HIV Algorithm

EXPOSURE
Is source material blood, bloody fluid, other
potentially infectious material or an instrument
contaminated with one of these substances?

YES NO NO PEP needed

What type of exposure?

Mucous membrane or skin Percutaneous Intact skin


integrity compromised exposure only
(eg. Dermatitis, open wound)

Volume Severity More Severe


e.g. large-bore
hollow needle,
Small Large Less Severe deep puncture,
e.g. few e.g. several e.g. solid visible blood
drops, short drops, major needle, scratch needle used in
duration blood splash blood vessel of
&/ longer source.
Duration
(several
minutes or
more)

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