Acupuncture and Chinese Medicine Clinical Student Handbook

Appendix E: Exposure Incident

This packet contains all of the forms and information needed to take care of an employee or student involved in an exposure incident.

Required Forms for Exposure Incident

Exposure Incident Instructions

Exposure Incident Instructions with Forms

Document A Exposure Incident Report

Document B Exposed Individual Consent for Testing

Document C Source Individual Consent for Testing

Document D Notice to Health Care Provider

What is an Exposure Incident?

Exposure Incident: “a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials (OPIM)* that results from the performance of an employee’s duties.” If you are unsure if an exposure incident occurred, administer first aid and then call either the exposure control officer or the appropriate supervisor of your school or college to determine if an exposure incident has occurred.

*OPIM = semen, vaginal secretions, cerebral spinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any bodily fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids.

You have determined that an exposure incident has occurred. Please, don’t panic. Occupational exposures should be considered urgent (not emergency) medical concerns to ensure timely post-exposure management and administration of HBIG, hepatitis B vaccine, and/or HIV PEP if necessary.

Follow the steps outlined below:

Step One:

Administer First Aid:

  • If this incident occurred in a patient care setting, ensure patient safety first.
  • Then, clean your wound with copious amounts of soap and water for 10-15 minutes or flush your eyes or other mucous membranes with water for 10-15 minutes.
  • Vigorous scrubbing should be avoided as this may damage the skin and increase the chance of disease transmission.
  • If there is a puncture wound (e.g. needle stick), you do not need to squeeze any blood out.
  • You do not need to apply alcohol, antiseptic or use bleach on the wound.

Step Two:

  • Notify your immediate supervisor* Failure to document an exposure incident may result in the denial of the claim or delay of payment for healthcare services.
  • If he/she is unavailable, call the Exposure Control Officer.
  • Your supervisor or the Exposure Control Officer will assist you with completion of the exposure incident documentation.

*Note to supervisor: you must contact the Exposure Control Officer within 24 hours of the incident.

Christian Jovanovic DACM, L.Ac

Exposure Control Officer

Office: 952-888-4777 x309

Cell: 612-203-2693

Step Three:

  • Complete Document A in as much detail as possible.
  • Make 3 copies: one for Human Resources, one for the Exposure Control Officer, one for the health care professional.

Step Four:

  • Sign the form regarding permission for testing of Exposed Individual. (Document B) Make 3 copies.

Step Five:

  • Identify the Source Individual (when possible) or unless prohibited by law. This is the person to whose blood or OPIM you were exposed.
  • The clinical supervisor of the exposed individual should contact the Source Individual to discuss blood testing and obtain consent.
    • Request and obtain permission for testing of Source Individual (if necessary). Fill out the Past Exposure Testing Consent form and have blood tested for HIV, HBsAg, and HCV antibody. If the Source Individual is immune to Hepatitis B (i.e. has had the vaccination), HBsAg testing is not necessary. (Document C) Make 3 copies.
    • If the Source Individual is already known to be HIV, HCV or HBV positive, new testing need not be performed.
    • If the Source individual refuses to be tested, it must be documented that legal consent was not obtained. (Document C)
    • If the Source individual cannot be identified, this must be documented. (Document C)

Step Six:

  • Within 2 hours of the incident the Exposed Individual should present to the university lab or an urgent health care clinic / ER for a medical evaluation. It is important that you don’t delay in getting care. Be prepared to have your blood drawn and to be counseled by a physician regarding your risks and management options such as post-exposure drug prophylaxis.

*Note: HIV prophylactic drugs are most effective when given within 4 hours of exposure. Hepatitis B Immune Globulin (HBIG) should be given as soon as possible after exposure, within the first 24 hours. Hepatitis B vaccine is given within seven days of exposure.

  • Bring a copy of the following forms with you when you go in for your medical evaluation:
    • Completed Documents A and B (if you are having lab work done there)
    • Notice to healthcare provider
    • Healthcare professional’s post exposure written opinion (Document D)
    • Completed Description of employee’s exposure-related job duties
    • Copy of OSHA’s Bloodborne Pathogens Standard
  • If you would rather have your blood drawn at the NWHSU laboratory, you will need to have the Past Exposure Testing consent form filled out, signed by a DC or MD, (test your blood for HIV, HBsAg, and HCV antibody; if you have had the hepatitis B vaccine series, you do not need to test for HBsAg) and make an appointment with Bloomington Health Clinic (formally known as Bloomington Natural Care Clinic).

Step Seven:

  • The exposed individual must make an appointment with the university’s Exposure Control Officer for follow-up counseling and paperwork within the next 2 weeks. Bring copies of all your blood work, forms from the clinic, and 2 copies of exposure incident report.

Step Eight:

  • It will be the exposed individual’s responsibility to make appropriate appointments for follow- up laboratory testing. They must contact the Exposure Control Officer for forms and call the clinical laboratory for an appointment.