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pep

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by

zeel kamdar

on 2 May 2013

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Transcript of pep

First Aid For Needle Stick Injury Exposure Long-term follow-up counselling and education


Testing for at least 6 months after exposure (e.g., 6 weeks, 12 weeks and 6 months)



If PEP is used: drug toxicity monitoring at baseline and after 2 weeks Follow-up Component 2-drug regimen (basic PEP regimen)
1st choice: BD
Zidovudine (AZT 300 mg) + Lamivudine (3TC 150 mg)

2nd choice: BD
Stavudine (d4T 30-40 mg)+ Lamivudine (3TC 150 mg)

3-drug regimen (expanded PEP regimen)

consult expert opinion for starting 3rd drug e.g. Nelfinavir (750mg tds), Lopinavir/ritonavir, or Indinavir

All regimen for 28 days

PEP can be given up to 72 hours after exposure, Preferably within 2 hours. PEP DRUGS Determining PEP recommendation First Aid (splash of blood or body fluids) Transmission Risk Potentially infectious body fluids Principles of providing PEP

Refers to the comprehensive management given to minimize the risk of infection following potential exposure to blood-borne pathogens (HIV, HBV, and HCV).

To understand
Risk from exposure
Various aspects of Post exposure prophylaxis
Source code
Exposure code
Regimens used for PEP Learning Objectives Do not panic ! Stay calm

Manage wound- First Aid

Report the exposure

Assess infection risk

Conduct appropriate treatment,
follow-up, and counselling Steps of Post-Exposure Management Take Home Messages Percutaneous injury Mucous membrane Non-intact skin Prolonged (several minutes) exposure to intact skin Non-discrimination Confidentiality Informed consent Exposure to body fluid considered as Risk Blood
Semen
Vaginal Secretion
Cerebro spinal Fluid
Synovial, Pleural,Peritonial fluid
Amniotic Fluid
Body fluid contaminated with Visible blood Body fliuds considered ' Not at Risk' Tears
Sweats
Urine and feaces
Saliva
(unless these secretions contain visible blood) Wash the wound with soap & water & rinse Do not scrub Do not use antiseptics or skin washes (bleach, chlorine, alcohol, betadine) Don’t suck the damage part Dont squeeze Irrigate exposed eye immediately with water or normal saline continuously. If wearing contact lens, leave them in place while irrigating. Spit fluid out immediately Magnitude of Risks 0.3% for HIV

3-10% for HCV

9 to 30% for HBV Immunization against Hepatitis B vaccine Take Precautions Post exposure prophylaxis (PEP) Interns Arjun Pinki Assesment of risk Report the Exposure Where should you contact for PEP in our Hospital ? What advice you will give to Arjun? Thank You Rinse the mouth thoroughly, using water or saline repeatedly.
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