A blood-exposure incident is defined as contact with blood or other potentially infectious materials that results in exposure to the eyes, mouth, non-intact skin, or through a puncture injury. This type of exposure often involves percutaneous injuries, such as needlesticks or cuts, or when fluids splash onto mucous membranes. Immediate action is paramount following any such incident, as rapid first aid significantly mitigates the risk of acquiring a bloodborne pathogen.
Immediate Site Care
The first action after an exposure is to focus on the contact site to reduce the inoculum of potentially infectious material. For a percutaneous injury, such as a needlestick or a cut, gently encourage the wound to bleed. This helps flush out contaminants, but do not aggressively squeeze or scrub the area, which could worsen tissue damage or drive contamination deeper. Following this initial flush, the wound must be thoroughly washed with soap and running water.
If the exposure involves mucous membranes (eyes, mouth, or nose), the area must be flushed immediately and copiously. Rinse continuously with clean water, saline solution, or sterile irrigants. For eye exposure, this continuous irrigation should last for at least 15 to 20 minutes to ensure adequate decontamination. Avoid using harsh disinfectants, such as alcohol or bleach, directly on the wound or mucous membranes, as these agents can irritate or damage the tissue.
Documentation and Reporting
Once immediate first aid is complete, the next step is the formal reporting of the incident. The exposed individual must immediately notify the designated party, such as a supervisor or safety officer. This notification initiates the official response protocol and ensures the exposed person receives appropriate follow-up care. Reporting the event is an urgent step that should not delay the subsequent medical evaluation.
The formal report requires gathering specific details necessary for risk assessment and follow-up. Documentation must include the exact date, time, and location of the exposure, a precise description of the procedure being performed, and the specific route of exposure (e.g., needlestick or splash). If the source of the blood or body fluid is known, information about that individual must also be collected, subject to privacy regulations.
Post-Exposure Medical Assessment
After reporting the incident, the exposed person must seek urgent medical evaluation from a qualified healthcare professional. This step is time-sensitive, particularly concerning the potential need for Post-Exposure Prophylaxis (PEP) against Human Immunodeficiency Virus (HIV). PEP is a regimen of antiretroviral medications that must be started as soon as possible after the exposure, ideally within hours, to be most effective.
The healthcare provider will conduct a thorough risk evaluation, taking into account the type of exposure and the known or suspected infectious status of the source individual. Testing is performed on the exposed person to establish a baseline status for bloodborne pathogens, including HIV, Hepatitis B (HBV), and Hepatitis C (HCV). Consent is required for testing, but a blood sample can be drawn and preserved for up to 90 days, allowing the exposed person time to decide whether to consent to HIV testing.
If the medical assessment determines a sufficient risk for HIV transmission, a 28-day course of PEP medications will be prescribed. PEP must be started within 72 hours of the exposure, as its effectiveness significantly decreases beyond this window. While PEP is available for HIV and HBV, there is no post-exposure prophylaxis available for HCV, making follow-up testing the primary management strategy. Follow-up testing for all relevant pathogens is conducted at specific intervals, typically at six weeks, three months, and six months, to confirm the individual’s long-term infection status.