Manual for Male Circumcision under Local Anaesthesia

Male circumcision under local anaesthesia
Version 3.1 (Dec09)
POST-EXPOSURE PROPHYLAXIS
Health care workers may be accidentally exposed to blood and other
body fluids that are potentially infected with HIV, hepatitis virus or
other bloodborne pathogens. Occupational exposure may occur
through direct contact of non-intact skin with potentially infected blood
or body fluids, from splashes into the eyes or mouth, or through injury
with a used needle or sharp instrument. Post-exposure prophylaxis
(PEP) can help prevent the transmission of pathogens after such a
potential exposure.
Managing occupational exposure to hepatitis B, hepatitis C and
HIV
The immediate response to exposure to blood or other fluids that are
potentially infected with hepatitis B virus (HBV), hepatitis C virus
(HCV) or HIV is as follows.
Step 1. Provide immediate first aid care to the exposure site:
• If a splash or a spill occurs on the skin, wash the area
immediately with soap and water. Do not use caustic agents,
alcohol or bleach, because they will irritate the skin and may
increase the risk of infection. Do not apply a dressing.
• If a splash or a spill occurs in the eyes, the nose, the mouth, or
on any mucous membrane, rinse the area with clean water for
at least 10 minutes.
• If an injury has been caused by a potentially contaminated
sharp, wash the area with soapy water, and allow the wound to
bleed freely for a few minutes if possible. Then give normal first
aid.
Step 2. Evaluate the risk by determining the type of fluid (blood, visibly
bloody fluid, or other potentially infectious fluid), the severity and type
of exposure (percutaneous or needle stick, mucous membranes, intact
or non-intact skin), and the source of infection.
Step 3: If the source person is identified, it is important to try to obtain
information on his or her hepatitis and HIV serostatus and, if positive,
an evaluation of the clinical status and treatment history.
• Assess the risk of infection, using available information.
• The source person may be tested only with his or her informed
consent.
• Do not test discarded needles or syringes for virus
contamination.
Management of exposure to hepatitis B
The medical response to exposure to hepatitis B virus (HBV) depends
on the patient's immune status, as determined by the history of
hepatitis B vaccination and vaccine response, and whether the
exposure poses a risk of infection. Transmission of HBV may occur
Prevention of Infection Chapter 8-16