Blood and body fluid exposure management update

Public Health and the Rapid Access Infectious Disease Clinic at the Jim Pattison Outpatient Service Centre (JPOCSC) have identified a few recurring issues for patients being managed for blood and body fluid exposure.

To improve the care for patients with blood and body fluid exposure, please take note of the following:

• Assessment of Source Person – If the source of the blood/body fluid exposure is known, an assessment of the source
  person is recommended. This assessment includes serology (HBsAg, anti-HBs, anti-HBc Total, anti-HCV, and HIV
  Ag/Ab), Hepatitis B vaccine history and immune status, and assessment of their risk factors for HCV and/or HIV.

• Initiating PEP – if assessment determines an exposure requires PEP, it should be started immediately in the ER. Please
  do not to send an urgent referral to Infectious Diseases Rapid Access Clinic at JPOCSC to initiate PEP.

• Making Follow-Up Plans – The exposed person requires continued follow up with a community health care provider
  regardless of whether or not PEP is started in ER. The exposed person can:

• Arrange follow up with their community health care provider or

• Be referred by ER to the Rapid Access Clinic at Jim Pattison Outpatient Care and Surgery Centre (JPOCSC). To
  refer the patient to JPOCSC complete the referral form – Rapid Access Medicine Clinic Referral Infectious
  Disease

• Follow-Up Physician Form – To assist with the follow-up process, complete the Management of Percutaneous or
  Permucosal Exposure to Blood or Body Fluid Letter for Follow-Up Physician Form (can be found by searching “HLTH
  2340”) and provide the white copy to the exposed person for follow up with a community health care provider.

The following are resources available to assist with management and follow-up of patients with blood and body fluid
exposures:

• Infectious Diseases Rapid Access Clinic at JPOCSC – Infectious Diseases physicians are available for consultation
  Monday to Friday from 9:00 a.m. to 5:00 p.m. excluding statutory holidays. They can be reached using the On-call Scheduling
  System, under:

• SMH – Infectious Disease – SMH Infectious Diseases Outside Telephone Consultation and Follow-up Service

• BC Centre for Excellence in HIV/AIDS – provides support and guidelines for prescribing post-exposure prophylaxis for
  HIV/AIDS.

• Guidelines are located on the British Columbia Centre for Excellence in HIV/AIDS website – Guidance for the use of Post-Exposure Prophylaxis (PEP) for the Prevention of HIV Acquisition British Columbia

• St Paul’s Hospital Ambulatory Pharmacy – experts are available regarding post-exposure prophylaxis for HIV
  by calling 1-888-511-6222 (24 hours a day, 7 days a week).

• BCCDC Blood and Body Fluid Exposure Management Guidelines – provides guidance for healthcare providers on the
  assessment of risk and management of persons potentially exposed to hepatitis B virus, hepatitis C virus and Human
  Immunodeficiency Virus transmission, through contact with blood and body fluids in a healthcare or community
  setting.

• Guidelines are located in the BCCDC Communicable Disease Manual – Blood and Body Fluid Exposure
  Management