Guidelines for INFECTION CONTROL POLICY - Safdarjung Hospital

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ANNEXURE-IIITHREE STEPS TO HIV POST-EXPOSURE PROPHYLAXIS (PEP)AFTER OCCUPATIONAL EXPOSUREStep-I : Determine the exposure code (EC)Is source material blood – bloody fuid, semen/vaginal fuild orother normally sterile fluid or tissue ?YesNoNo PEPRequiredWhat type ofexposure occurred ?Mucous members or skinintegrity compromised(e.g. Dermatitis, openwould)VolumeIntack SkinNo PEPPercutaneouse exposure :SeveritySeveritySmall :Few DropsLarge : Majorsplash & / orlong durationLess severe :Solid needle,scratchMore severe : Largebore hollow needledeep puncture,visible blood, needleused in blood vesselEC 1Of sourceEC 2 EC 2 EC 340
Step-II : Determine the HIV STATUS Code (HIV SC)What is the HIV status of the exposure source ?HIV Negative HIV Positive Status unknown Status unknownNo PEP Low titre exposure :Asymptomatic andHigh CD 4countHigh titre exposure :Advanced AIDS,primary HIV, highviral load or low CD 4HIV SCunkonownHIV SCHIV SCStep 3 : Determine Post-Exposure Prophylaxis(PEP) RecommendationEC HIV SC PEP1 1 Consider basic1 2 Recommend basic regimen2 1 Recommend expanded regimen3 1 or 2 Recommend expanded regimen1,2,3, Unknown If exposure setting suggests risks of HIVExposure, consider basic regimenBasic Regimen : Zidovucine (AZT)-600 in divided doses (300 mg) twice a day or 200 mg (thricea day) for 4 weeks + Lamiondine (3TC)- 150 mg twice a day for 4 weeks.Expanded Regimen : Basic regimen + Indinavir-800 mg thrice a day. or any other proteaseinhibitor.Pregnancy and PEPBased on limited information, anti retroviral therapy taken during 2 nd and 3 rd trimester ofpregnancy has not caused serious side effects in mother and infants. There is very littleinformation on the safety in the 1sr trimester. If the HCW is pregnant a time of exposure toHIV, the designated authority or physician must be consulted about the use of the drugs andPEP.Dept. of Medicine & Dept. of Hesp. Waste Management, SJH41
Page 2 and 3: CONTRIBUTORSCreated by : Dr. Rajni
Page 5 and 6: HOSPITAL INFECTION CONTROL TEAM (HI
Page 7 and 8: 12. Training and education of HCW C
Page 9 and 10: Schedule may be changed to increase
Page 11 and 12: Semi-critical instruments /equipmen
Page 13 and 14: • The isolation of the patient wo
Page 15 and 16: Microbiological StudyMicrobiologica
Page 17 and 18: Annexure-1Policy on‘Hospital Wast
Page 19 and 20: CONTENTSTOPIC SUB-TOPIC PAGE NO.1.
Page 21 and 22: HOSPITAL WASTE MANAGEMENT COMMITTEE
Page 23 and 24: Color-coded bags & Category wise Tr
Page 25 and 26: MAINTENANCE OF EQUIPMENTMaintenance
Page 27 and 28: • Labelled as with ‘Cytotoxic
Page 29 and 30: MERCURY SPILL MANAGEMENT :If accide
Page 31 and 32: FUTURE PROPOSAL FOR DISPOSAL OF RAD
Page 33 and 34: Minimization (ofwaste)MonitoringOn-
Page 35 and 36: PERFORMA OF BIOMEDICAL WASTE MANAGE
Page 37 and 38: ANNEXURE-2PROTOCOL FOR MANAGEMENT O
Page 39: ANNEXURE-IIRECOMMENDED POSTEXPOSURE

Guidelines for INFECTION CONTROL POLICY - Safdarjung Hospital

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