Emergency & Exposure
If an exposure incident occurs, time is the most important variable. Do not delay first aid while looking for forms or waiting for a supervisor.
Exposure Type
Needlestick / Sharps Injury
Immediate Response (First 2 Minutes)
Do not panic
Wash the wound
Use running water immediately. Soap if available.
Do not squeeze, suck, or apply caustic agents
Bandage with a sterile dressing
Complete first aid before moving to reporting and risk assessment. [1]
Within 24 Hours
Report to your location supervisor
Do this immediately after first aid.
See MO/FMS for risk assessment
- Source patient HIV / Hep B / Hep C status
- Nature and depth of injury
- Volume of blood involved
Start PEP if indicated
- HIV PEP: Ideally within 2 hours, effective up to 72 hours [1]
- Hep B PEP: Ideally within 24 hours
Document the incident
- Supervisor files OHU/SIS-1 and SIS-2 forms.
- Enter into the Sharps Injury Surveillance (SIS) system.
The effectiveness of HIV post-exposure prophylaxis drops sharply after 2 hours. If the source patient is HIV-positive or of unknown status, do not wait — initiate the PEP pathway immediately while awaiting formal risk assessment.
Sharp Injury Surveillance (SIS) Forms
Blood or Body Fluid Splash to Mucosa
Eyes
- Irrigate immediately with clean water or normal saline.
- Continue for 10–15 minutes. [1]
- Do not rub the eyes.
- Remove contact lenses if present (after initial flush).
Mouth / Nose
- Spit out any fluid immediately.
- Rinse mouth thoroughly with water repeatedly.
- Blow nose gently and discard tissue into clinical waste.
- Do not swallow.
After Initial Decontamination
- Report to supervisor immediately.
- Same PEP pathway as needlestick — see MO/FMS within 2 hours for HIV risk.
- Document incident and source patient details.
Post-Exposure Prophylaxis Timeline
| Pathogen | PEP Window | Regimen | Follow-up |
|---|---|---|---|
| HIV | ≤2 hours ideal, ≤72 hours acceptable | Triple ARV (consult MO/FMS) | Baseline test at 0, 6 weeks, 3 months, 6 months |
| Hepatitis B | ≤24 hours | Hep B vaccine booster ± HBIG if non-immune | Baseline anti-HBs, repeat at 1–2 months |
| Hepatitis C | No proven PEP | Baseline testing, early treatment if seroconversion | Baseline HCV RNA, repeat at 4–6 weeks |
With consent, test the source patient for HIV, HBsAg, and anti-HCV. If the source is unknown (e.g., discarded needle in public area), assume the highest risk and proceed with PEP.
Who to Contact [1]
Incident Documentation
Every exposure must be documented in the Sharps Injury Surveillance (SIS) system:
- Date, time, and location of incident
- Nature of exposure (needlestick, splash, depth, volume)
- Source patient information (if known)
- PEP given (drug names, start time)
- Follow-up appointments scheduled
Even if the exposure seems minor or the source patient tests negative, document the incident. SIS data drives clinic-level safety improvements and PEP supply forecasting.
Quick Action Card
Wash / Irrigate
Run water over the wound immediately. For eye or mouth splash, irrigate for 10–15 minutes.
Report to Supervisor
Inform your supervisor immediately after first aid — in person or by phone.
PEP Assessment
See MO/FMS within 2 hours for risk assessment. Start HIV PEP immediately if indicated.
Document in SIS
Complete OHU/SIS-1 and SIS-2 forms. Enter the incident into the SIS system within 24 hours.
For a printable version, see the Exposure Visual Checklist.