Blood borne viruses
From WardWiki - Foundation Doctor Helper
Blood borne viruses are important in foundation medicine both for one's own safety as well as that of the patient. Please ensure familiarity with trust occupational health advice and seek at no point to participate in exposure prone procedures without clearance from OH department. Doing so will question the character of the doctor and any litigation resulting from such a procedure will almost ceretainly be outside crown immunity - DO NOT SHORTCUT STANDARD SAFETY PROCEDURES FOR PERSONAL OR CAREER GAIN.
All viruses may technically be blood borne, the term is limited in medicine to the following:
- Human Immunodeficiency Virus Types I and II
- Human T-lymphotrophic virus
- Hepatitis B Virus
- Hepatitis C Virus
- Hepatitis D Virus
Special consideration should be given to immunosupressed patients in regard to cytomegalovirus. This can cause serious illness in such patients. Learn if possible if such a patient has previously been exposed to the virus when considering infusing blood products or when listing for bone marrow transplantation or solid organ transplantation.
Do NOT transmit CMV to any patient immunosuppressed either by medications or those that may soon be. Those likely to immunosuppressed in the near future are those awaiting organ transplantation or chemotherapy. High risk chemotherapy agents have been given as fludarabine or cladrabine but it is best to obtain a haematology team referral whenever in doubt as the results of not doing can be disastrous.
If such advice is not forthcoming then ordering CMV negative blood is safer than risking tranmission; it also acts as a useful trigger for advice as someone must sanction CMV negative blood.
If you pierce, or puncture, your skin with a used needle, you need first aid straightaway. You should:
- Encourage the wound to bleed, ideally by holding it under running water
- Wash the wound using running water and plenty of soap
- Dry the wound, and cover it with a waterproof plaster, or dressing.
Do not scrub the wound while you’re washing it, and do not suck the wound. In the hospital you must contact occupational health. They may test the patient for blood borne viruses but on no account should the injured party attempt to do this as this can be seen as coercive and unethical. The patient is under no legal obligation to comply under UK law.
Post exposure prophylaxis will be considered by the occupational health department.
- Washing hands after contact with each patient
- Washing hands after handling blood, or body fluids
- Always wearing disposable gloves when working with blood or body fluids
- Protecting your eyes, by wearing a visor, goggles, or safety spectacles
- Covering any cuts with waterproof plasters, anddisposing of used needles and sharps safely.