An exposure incident is defined as contact with blood or other potentially infectious materials (OPIM) through a break in the skin, a needlestick injury, or a splash to the eyes, nose, or mouth. This contact creates a risk for transmitting bloodborne pathogens such as Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV). The single most important factor in limiting potential infection is speed, requiring immediate action. An effective response involves time-sensitive steps, starting with decontamination and quickly moving to medical assessment and treatment.
Immediate First Aid and Site Management
The first step after an exposure incident is physical decontamination of the contact area, which must precede any administrative action. For a percutaneous injury, such as a needlestick or a cut with a contaminated sharp, the injury site should be immediately washed thoroughly with soap and running water. Encourage bleeding at the wound site, but avoid squeezing or milking the wound, as this can force infectious material deeper into the tissue.
If the exposure involves contact with skin, the affected area needs to be washed with soap and water for several minutes. This mechanical action helps remove the infectious material from the skin’s surface. If the exposure is to a mucous membrane, such as the eyes, nose, or mouth, the area must be flushed continuously with clean water or a saline solution.
For eye or mouth exposure, the irrigation should be sustained for at least 15 minutes to maximize the removal of infectious agents. The goal of this immediate first aid is to reduce the concentration of the pathogen at the site of exposure. This prompt action of physical decontamination is the first barrier against potential infection and must be done without delay.
The Essential Steps for Reporting
Once immediate first aid is complete, the next step is reporting the incident. The exposed person must notify their direct supervisor or designated safety officer immediately. This communication activates the formal medical and investigative protocol, and delaying the report can significantly hinder the subsequent, time-dependent medical response.
The reporting process requires completing detailed documentation, typically an incident report form. This form captures precise information about the event, including the exact time and location of the exposure. It is necessary to record the type of material involved (e.g., blood or OPIM) and the route of exposure (e.g., puncture or splash).
If the source of the infectious material is known, that information should be documented to facilitate a risk assessment later. The timely and accurate completion of this report is a regulatory requirement that ensures the exposed individual receives the necessary medical follow-up. This administrative step creates the official record needed to move on to the medical assessment phase.
Post-Exposure Medical Assessment and Treatment
Following first aid and reporting, the exposed individual must seek an immediate medical evaluation from a healthcare professional specializing in occupational health. This assessment is urgent, as the effectiveness of preventive treatment is tied to the speed of initiation. The clinician will conduct a risk assessment based on the type of exposure, the volume of material involved, and the known or suspected infection status of the source.
This evaluation involves testing the exposed individual for baseline status regarding bloodborne pathogens like HIV, HBV, and HCV. If the source is known and consent is obtained, their blood will also be tested to determine the presence of these pathogens. This dual testing helps the clinician make an informed decision about the appropriate course of action.
Post-Exposure Prophylaxis (PEP) may be offered, involving a 28-day course of antiretroviral medications to prevent HIV infection. The timing for starting PEP is sensitive: it should be initiated as soon as possible, ideally within two hours of exposure, and certainly no later than 72 hours. Starting PEP after this 72-hour window is generally considered ineffective.
The exposed person will also be scheduled for follow-up testing and counseling, typically extending over several months. This continued care includes repeat testing for HIV, HBV, and HCV at specific intervals after the exposure, often at six weeks, three months, and six months. The entire medical process is designed to reduce the risk of infection and provide support to the exposed individual.