Harbor:Occupational exposure - Revision history

Bchap23 at 16:33, 27 January 2026

2026-01-27T16:33:17Z

← Revisión anterior		Revisión del 16:33 27 ene 2026
Línea 6:		Línea 6:
	** Employee with potential blood-borne pathogen exposure should be evaluated in ED		** Employee with potential blood-borne pathogen exposure should be evaluated in ED
	*** Charge RN has the exposure packet (needs to be filled out to avoid employee getting the bill)		*** Charge RN has the exposure packet (needs to be filled out to avoid employee getting the bill)
	*** <big><big>Use autotext '''.~~edexposure~~''' for documentation template and guidance text on when to consult HIV service</big></big>		*** <big><big>Use autotext '''.edExposure''' for documentation template and guidance text on when to consult HIV service</big></big>
	***'''Source patient''': Orchid '''Blood or Body Fluid Exposure - Source Patient''' order set includes:		***'''Source patient''': Orchid '''Blood or Body Fluid Exposure - Source Patient''' order set includes:
	**** HIV Antibody/antigen screen		**** HIV Antibody/antigen screen
Línea 16:		Línea 16:
	**** Ensure employee has Hep B vaccine		**** Ensure employee has Hep B vaccine
	**** '''No blood testing of the employee in the ED''' for privacy reasons		**** '''No blood testing of the employee in the ED''' for privacy reasons
	***'''Call HIV service if the source patient's Rapid HIV is positive or is untestable''' AND was a clinically meaningful exposure (see .~~edexposure~~ autotext)		***'''Call HIV service if the source patient's Rapid HIV is positive or is untestable''' AND was a clinically meaningful exposure (see .edExposure autotext)
	***If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health the next day; '''first dose can be given in the ED'''		***If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health the next day; '''first dose can be given in the ED'''
	**** '''PEP must be prescribed to the Harbor Pharmacy''' to avoid generating a bill for the employee (patient)		**** '''PEP must be prescribed to the Harbor Pharmacy''' to avoid generating a bill for the employee (patient)

Bchap23 at 16:25, 27 January 2026

2026-01-27T16:25:25Z

← Revisión anterior		Revisión del 16:25 27 ene 2026
Línea 6:		Línea 6:
	** Employee with potential blood-borne pathogen exposure should be evaluated in ED		** Employee with potential blood-borne pathogen exposure should be evaluated in ED
	*** Charge RN has the exposure packet (needs to be filled out to avoid employee getting the bill)		*** Charge RN has the exposure packet (needs to be filled out to avoid employee getting the bill)
	*** Use autotext '''.edexposure''' for documentation template and guidance text on when to consult HIV service		*** <big><big>Use autotext '''.edexposure''' for documentation template and guidance text on when to consult HIV service</big></big>
	***'''Source patient''': Orchid '''Blood or Body Fluid Exposure - Source Patient''' order set includes:		***'''Source patient''': Orchid '''Blood or Body Fluid Exposure - Source Patient''' order set includes:
	**** HIV Antibody/antigen screen		**** HIV Antibody/antigen screen
Línea 15:		Línea 15:
	***'''Employee'''		***'''Employee'''
	**** Ensure employee has Hep B vaccine		**** Ensure employee has Hep B vaccine
	**** '''no blood testing of the employee in the ED''' for privacy reasons		**** '''No blood testing of the employee in the ED''' for privacy reasons
	***'''Call HIV service if the source patient's Rapid HIV is positive or is untestable''' AND was a clinically meaningful exposure (see ~~occupational exposure template https://www.wikem~~.~~org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure~~)		***'''Call HIV service if the source patient's Rapid HIV is positive or is untestable''' AND was a clinically meaningful exposure (see .edexposure autotext)
	***If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health the next day; '''first dose can be given in the ED'''		***If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health the next day; '''first dose can be given in the ED'''
	**** PEP must be prescribed to the Harbor Pharmacy to avoid generating a bill for the employee(patient)		**** '''PEP must be prescribed to the Harbor Pharmacy''' to avoid generating a bill for the employee (patient)
	*Additional info in "INDUSTRIAL ACCIDENTS" section below


	==See Also==		==See Also==
	*[[Harbor:Main]]		*[[Harbor:Main]]
	*[[Harbor:Occupational exposure (dot-phrases)]]
	*[[Occupational Exposure]]		*[[Occupational Exposure]]
	*[[HIV Prophylaxis (Occupational)]]		*[[HIV Prophylaxis (Occupational)]]

	~~=References=~~
	~~<References/>~~
	~~HUCLA~~

	[[Category: Admin]]		[[Category: Admin]]

Bchap23 at 16:14, 27 January 2026

2026-01-27T16:14:17Z

← Revisión anterior		Revisión del 16:14 27 ene 2026
Línea 19:		Línea 19:
	***If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health the next day; '''first dose can be given in the ED'''		***If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health the next day; '''first dose can be given in the ED'''
	**** PEP must be prescribed to the Harbor Pharmacy to avoid generating a bill for the employee(patient)		**** PEP must be prescribed to the Harbor Pharmacy to avoid generating a bill for the employee(patient)
	*Message Jeremy Ramon at Employee Health after any exposure to ensure follow-up
	*Additional info in "INDUSTRIAL ACCIDENTS" section below		*Additional info in "INDUSTRIAL ACCIDENTS" section below

Bchap23 at 19:45, 24 September 2025

2025-09-24T19:45:32Z

← Revisión anterior		Revisión del 19:45 24 sep 2025
Línea 1:		Línea 1:
			* [https://lacounty-my.sharepoint.com/personal/spouv_dhs_lacounty_gov/_layouts/15/stream.aspx?id=%2Fpersonal%2Fspouv%5Fdhs%5Flacounty%5Fgov%2FDocuments%2FBlood%20Exposure%20Presentation%2FBlood%20Exposure%20Presentation%20for%20Healthcare%20Facilities%5FHUCL Employee Health Guidance Video]
	*'''Exposure during weekdays (non-holidays), from 7:00a-3:30p:'''		*'''Exposure during weekdays (non-holidays), from 7:00a-3:30p:'''
	** Send employee directly to Employee Health office for evaluation unless the employee has sustained an injury that warrants ED evaluation (i.e. laceration)		** Send employee directly to Employee Health office for evaluation unless the employee has sustained an injury that warrants ED evaluation (i.e. laceration)

Bchap23 at 23:53, 7 May 2025

2025-05-07T23:53:07Z

← Revisión anterior		Revisión del 23:53 7 may 2025
Línea 6:		Línea 6:
	*** Charge RN has the exposure packet (needs to be filled out to avoid employee getting the bill)		*** Charge RN has the exposure packet (needs to be filled out to avoid employee getting the bill)
	*** Use autotext '''.edexposure''' for documentation template and guidance text on when to consult HIV service		*** Use autotext '''.edexposure''' for documentation template and guidance text on when to consult HIV service
	***Source patient: ~~Employee~~'~~s supervisor should tell the source patient~~'~~s provider to order Rapid HIV, Hep B Surface Antigen and Hep C RNA “HCV RNA RT_PCR Quantitative-PHL” using "~~Blood or Body Fluid Exposure - Source Patient" order set ~~on source patient (consent~~ not needed if lab already has blood sample to add on test).		***'''Source patient''': Orchid '''Blood or Body Fluid Exposure - Source Patient''' order set includes:
	**** '''If source patient refuses HIV, it can be added on to a pre-existing blood specimen but the results may not be shared with the patient''' (HIV=gold top ... as is chem, LFT, TSH)		**** HIV Antibody/antigen screen
	***Employee~~: ensure~~ employee has Hep B vaccine; '''no blood testing of the employee in the ED''' for privacy reasons		**** Hepatitis B Surface Antigen
			**** HCV Quantitative Dx Assay
			**** Consent not needed if lab already has blood sample to add on test
			***** '''If source patient refuses HIV, it can be added on to a pre-existing blood specimen but the results may not be shared with the patient''' (HIV=gold top ... as is chem, LFT, TSH)
			***'''Employee'''
			**** Ensure employee has Hep B vaccine
			**** '''no blood testing of the employee in the ED''' for privacy reasons
	***'''Call HIV service if the source patient's Rapid HIV is positive or is untestable''' AND was a clinically meaningful exposure (see occupational exposure template https://www.wikem.org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure)		***'''Call HIV service if the source patient's Rapid HIV is positive or is untestable''' AND was a clinically meaningful exposure (see occupational exposure template https://www.wikem.org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure)
	***If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health the next day; '''first dose can be given in the ED'''		***If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health the next day; '''first dose can be given in the ED'''

Bchap23 at 22:47, 17 March 2025

2025-03-17T22:47:36Z

← Revisión anterior		Revisión del 22:47 17 mar 2025
Línea 5:		Línea 5:
	** Employee with potential blood-borne pathogen exposure should be evaluated in ED		** Employee with potential blood-borne pathogen exposure should be evaluated in ED
	*** Charge RN has the exposure packet (needs to be filled out to avoid employee getting the bill)		*** Charge RN has the exposure packet (needs to be filled out to avoid employee getting the bill)
	*** Use autotext ".~~edexposureharbor"~~ for documentation template and guidance text on when to consult HIV service		*** Use autotext '''.edexposure''' for documentation template and guidance text on when to consult HIV service
	***Source patient: Employee's supervisor should tell the source patient's provider to order Rapid HIV, Hep B Surface Antigen and Hep C RNA “HCV RNA RT_PCR Quantitative-PHL” using "Blood or Body Fluid Exposure - Source Patient" order set on source patient (consent not needed if lab already has blood sample to add on test).		***Source patient: Employee's supervisor should tell the source patient's provider to order Rapid HIV, Hep B Surface Antigen and Hep C RNA “HCV RNA RT_PCR Quantitative-PHL” using "Blood or Body Fluid Exposure - Source Patient" order set on source patient (consent not needed if lab already has blood sample to add on test).
	**** '''If source patient refuses HIV, it can be added on to a pre-existing blood specimen but the results may not be shared with the patient''' (HIV=gold top ... as is chem, LFT, TSH)		**** '''If source patient refuses HIV, it can be added on to a pre-existing blood specimen but the results may not be shared with the patient''' (HIV=gold top ... as is chem, LFT, TSH)
Línea 11:		Línea 11:
	***'''Call HIV service if the source patient's Rapid HIV is positive or is untestable''' AND was a clinically meaningful exposure (see occupational exposure template https://www.wikem.org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure)		***'''Call HIV service if the source patient's Rapid HIV is positive or is untestable''' AND was a clinically meaningful exposure (see occupational exposure template https://www.wikem.org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure)
	***If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health the next day; '''first dose can be given in the ED'''		***If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health the next day; '''first dose can be given in the ED'''
			**** PEP must be prescribed to the Harbor Pharmacy to avoid generating a bill for the employee(patient)
	*Message Jeremy Ramon at Employee Health after any exposure to ensure follow-up		*Message Jeremy Ramon at Employee Health after any exposure to ensure follow-up
	*Additional info in "INDUSTRIAL ACCIDENTS" section below		*Additional info in "INDUSTRIAL ACCIDENTS" section below

Bchap23 at 16:59, 16 March 2025

2025-03-16T16:59:27Z

@@ Línea 1: / Línea 1: @@
 *'''Exposure during weekdays (non-holidays), from 7:00a-3:30p:'''
-**Send employee directly to Employee Health office for evaluation
+** Send employee directly to Employee Health office for evaluation unless the employee has sustained an injury that warrants ED evaluation (i.e. laceration)
 **Goal time from exposure to Employee Health office < 15 minutes
 *'''Exposure during all other times:'''
-**Employee with potential blood-borne pathogen exposure should be evaluated in ED
+** Employee with potential blood-borne pathogen exposure should be evaluated in ED
-**Create and use [[Harbor:Occupational_exposure_(dot-phrases)|"Occupational Exposure" dot-phrases]] to guide evaluation, assess risk, need for testing, and indications for obtaining ID/HIV consult
+*** Charge RN has the exposure packet (needs to be filled out to avoid employee getting the bill)
-**If exposure warrants rapid HIV test on the source patient, then must give source patient opportunity to opt out of HIV test
+*** Use autotext ".edexposureharbor" for documentation template and guidance text on when to consult HIV service
 ==See Also==

Jroh at 22:18, 14 March 2025

2025-03-14T22:18:05Z

← Revisión anterior		Revisión del 22:18 14 mar 2025
Línea 5:		Línea 5:
	*Employee: ensure employee has Hep B vaccine; '''no blood testing of the employee in the ED''' for privacy reasons		*Employee: ensure employee has Hep B vaccine; '''no blood testing of the employee in the ED''' for privacy reasons
	*Call HIV service if source patient Rapid HIV is positive or is untestable AND was a clinically meaningful exposure (see occupational exposure template https://www.wikem.org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure)		*Call HIV service if source patient Rapid HIV is positive or is untestable AND was a clinically meaningful exposure (see occupational exposure template https://www.wikem.org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure)
			*If HIV Service recommends PEP, ED will prescribe initial prescription and the patient will follow-up at Employee Health next day
	*Message Erika Sweet at Employee Health after any exposure to ensure follow-up		*Message Erika Sweet at Employee Health after any exposure to ensure follow-up
	*Additional info in "INDUSTRIAL ACCIDENTS" section below		*Additional info in "INDUSTRIAL ACCIDENTS" section below

Andreawu at 02:03, 30 December 2022

2022-12-30T02:03:04Z

← Revisión anterior		Revisión del 02:03 30 dic 2022
Línea 2:		Línea 2:
	*Use autotext ".edexposureharbor" for documentation template and guidance text on when to consult HIV service		*Use autotext ".edexposureharbor" for documentation template and guidance text on when to consult HIV service
	*Source patient: Employee's supervisor should tell the source patient's provider to order Rapid HIV, Hep B Surface Antigen and Hep C RNA “HCV RNA RT_PCR Quantitative-PHL” using "Blood or Body Fluid Exposure - Source Patient" orderset on source patient (consent not needed if lab already has blood sample to add on test).		*Source patient: Employee's supervisor should tell the source patient's provider to order Rapid HIV, Hep B Surface Antigen and Hep C RNA “HCV RNA RT_PCR Quantitative-PHL” using "Blood or Body Fluid Exposure - Source Patient" orderset on source patient (consent not needed if lab already has blood sample to add on test).
	***If source patient refuses HIV, it can be added on to a pre-existing blood specimen but the results may not be shared with the patient		**If source patient refuses HIV, it can be added on to a pre-existing blood specimen but the results may not be shared with the patient
	*Employee: ensure employee has Hep B vaccine; '''no blood testing of the employee in the ED''' for privacy reasons		*Employee: ensure employee has Hep B vaccine; '''no blood testing of the employee in the ED''' for privacy reasons
	*Call HIV service if source patient Rapid HIV is positive or is untestable AND was a clinically meaningful exposure (see occupational exposure template https://www.wikem.org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure)		*Call HIV service if source patient Rapid HIV is positive or is untestable AND was a clinically meaningful exposure (see occupational exposure template https://www.wikem.org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure)

Andreawu at 02:02, 30 December 2022

2022-12-30T02:02:48Z

← Revisión anterior		Revisión del 02:02 30 dic 2022
Línea 2:		Línea 2:
	*Use autotext ".edexposureharbor" for documentation template and guidance text on when to consult HIV service		*Use autotext ".edexposureharbor" for documentation template and guidance text on when to consult HIV service
	*Source patient: Employee's supervisor should tell the source patient's provider to order Rapid HIV, Hep B Surface Antigen and Hep C RNA “HCV RNA RT_PCR Quantitative-PHL” using "Blood or Body Fluid Exposure - Source Patient" orderset on source patient (consent not needed if lab already has blood sample to add on test).		*Source patient: Employee's supervisor should tell the source patient's provider to order Rapid HIV, Hep B Surface Antigen and Hep C RNA “HCV RNA RT_PCR Quantitative-PHL” using "Blood or Body Fluid Exposure - Source Patient" orderset on source patient (consent not needed if lab already has blood sample to add on test).
			***If source patient refuses HIV, it can be added on to a pre-existing blood specimen but the results may not be shared with the patient
	*Employee: ensure employee has Hep B vaccine; '''no blood testing of the employee in the ED''' for privacy reasons		*Employee: ensure employee has Hep B vaccine; '''no blood testing of the employee in the ED''' for privacy reasons
	*If source patient refuses HIV, it can be added on to a pre-existing blood specimen but the results may not be shared with the patient
	*Call HIV service if source patient Rapid HIV is positive or is untestable AND was a clinically meaningful exposure (see occupational exposure template https://www.wikem.org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure)		*Call HIV service if source patient Rapid HIV is positive or is untestable AND was a clinically meaningful exposure (see occupational exposure template https://www.wikem.org/wiki/Harbor:_Macros_and_Autotext#Occupational_Exposure)
	*Message Erika Sweet at Employee Health after any exposure to ensure follow-up		*Message Erika Sweet at Employee Health after any exposure to ensure follow-up