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Section: UTMB On-line Documentation
Subject: Healthcare Epidemiology Policies and Procedures
Topic: Reporting and Notification of Emergency Personnel, Peace
Officers, Correctional Officers, and Firefighters of Possible
Exposure to a Communicable Disease
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1.26 - Policy
02.08.07 - Revised
1990 - Author
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1.26 Reporting and Notification of Emergency Personnel, Peace Officers, Correctional Officers and Firefighters of Possible Exposure to a Communicable Disease
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Audience
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All emergency medical service employees, peace officers, correctional officers and firefighters (transporters).
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Policy
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The Communicable Disease Prevention and Control Act (Act '81.048), requires a licensed hospital to notify a health authority in certain instances when an emergency medical service employee, a peace officer, correctional officer or a firefighter (transporter) may have been exposed to a communicable disease during the course of duty from a person delivered to the hospital under conditions that were favorable for transmission.
Any emergency medical service employee, peace officer, correctional officer or firefighter (transporter) who believes he has experienced a “possible exposure” to a communicable disease during the course of duty shall complete a “Report of Possible Exposure of Transporter” form available in the UTMB Emergency Department.
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Possible Exposure
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Possible exposures include but are not limited to:
• Mouth-to-mouth resuscitation
• Penetrating puncture of the skin with a contaminated needle or other sharp item
• Splash or aerosol into the eye, nose, or mouth with blood or bloody body fluids
• Any significant contamination of an open wound or non-intact skin with blood or bloody body fluids.
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Procedure
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• The transporter is registered into the Emergency Department (ED)
• The transporter fills out the form “REPORT OF POSSIBLE EXPOSURE OF TRANSPORTER”. (If possible, document the date of birth or UH# of the source of the exposure).
• This form is given to the ED Charge Nurse. The ED Charge Nurse then faxes this form to the Department of Healthcare Epidemiology (HCE) at # 22337.
• Consent for HIV testing must be obtained from the source of the exposure.
• Source blood should be sent using the lab slip in the Bloodborne Pathogens Packet marked “Source Exposure Profile”. See IC Policy 1.02 Bloodborne Pathogens (BDP) Occupational Exposure.
• Transporters requesting prophylaxis will get a 2-3 day prescription. The transporter will need to bill their WCI office for the medication and ED visit.
• Blood must be drawn prior to giving medication.
• Consent for HIV testing must be obtained.
• Transporter blood should be sent using the lab slip in the Bloodborne Pathogens Packet marked “Student/Employee Exposure Profile”. Indicate on the lab slip that this was a transporter exposure (i.e., EMS, Police Officer, etc.).
• The transporter should then report to their Department Health Safety Officer for proper follow-up.
• If it is determined that the source of the exposure has a reportable bloodborne disease, HCE will notify the Galveston County Health Department (GCHD). The Report of Exposure form will be sent to GCHD with the following information:
o Name of exposed transporter
o Date of the exposure
o Type of exposure
o Disease or condition to which exposure may have occurred
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References
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1. Rules and Regulation for the Control of Communicable Disease and Reporting of Occupational Diseases, 25 TAC, Section 97.1 - 97.11, Procedures for Reporting of Transport Exposures, Austin-Travis County Health Department.
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REPORT OF POSSIBLE EXPOSURE OF TRANSPORTER
Any transporter who has one of the exposures listed in #2 below must complete this form immediately. The completed form should be placed in the designated receptacle provided by the hospital where the patient is delivered. ITEMS 1-5 are to be completed by the transporter. Questions in the box are to be completed by the hospital.
PLEASE PRINT LEGIBLY
ITEMS 1-5 TO BE COMPLETED BY THE TRANSPORTER:
1. The exposure described in #2 below occurred in the care of the following patient/person:
______________________________ /on ____/____/____/ - _______________AM/PM
(Patient Name) (Date) (Time)
Taken to: ____________________________________________________
(Facility)
HOSPITALS: Cut on dotted line and send this lower portion only to your health authority. You may wish to keep a copy for your records.
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2. Describe the details of contact with blood or body fluids.
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TYPE OF EXPOSURE (check those that apply)
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ADDITIONAL DESCRIPTION
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Mouth to mouth resuscitation
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Intubation
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Throat exam
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Suctioning
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BLOOD AND/OR
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BODY FLUID contact with:
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Eyes
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Nose
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Mouth
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Puncture or cut with Needle or Sharp object
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Open wound/lesion
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Non-intact skin
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SELF-FIRST AID MUST BE DONE AS SOON AS POSSIBLE FOLLOWING ONE OF THE ABOVE EXPOSURES. RINSE/FLUSH THOROUGHLY THE BODY PART EXPOSED TO BLOOD/BODY FLUIDS.
Follow with antimicrobial scrubbing of the exposed area, if not contraindicated, (ie, eyes, etc)
3. TRANSPORTER NAME: ____________________________________________________________________________________
4. TELEPHONE: (home) _______________________________ (work) _______________________________________
Name of EMPLOYER/AGENCY (EMS/FIRE/POLICE): __________________________________________________________
5. Address: _______________________________ City: ________________________ Telephone #: _______________
6. Transporter Signature: ___________________________________ Date Form Completed: _____/____/____
TO BE COMPLETED BY THE HOSPITAL:
_ DISEASE * IDENTIFIED _____________________________ ____/____/____/
(name of disease) (date specimen collected )
_ NO DISEASE * IDENTIFIED DURING THIS HOSPITALIZATION
REPORTED TO HEALTH AUTHORITY BY TELEPHONE (for true exposures only).
Name of agency: ________________________ Person contacted: _____________________________
Date Contacted: ____/____/____ By: __________________________
NAME/TITLE OF PERSON COMPLETING THIS SECTION: ________________________________________
SIGNATURE: _____________________________________ DATE: ____/____/____
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