Program Manual - Saint Louis University

C. Tetanus: One of #1 - #3 must be completed:
1. Documentation of tetanus booster within the last 10 years.
2. Tetanus diphtheria booster will be administered at the time of pre-placement exam unless contraindicated.
3. If the HCW does not wish to receive the vaccine, a refusal must signed. HCW is cleared for patient care.
4. Follow up for existing HCWs: A tetanus diphtheria booster is administered every 10 years or if indicated for
a work related injury.
5. Records of screening and/or vaccination will be maintained in the Employee Health HCW file.
D. Varicella Zoster: One of #1 - #2 must be completed:
1. HCW will complete medical history question indicating a prior varicella zoster (chickenpox) disease history.
2. If the HCW has no history of varicella zoster (chickenpox), a varicella titer will be drawn.
a- If the varicella titer is positive, no further action needed.
b- If the varicella titer is negative, the HCW is required to be vaccinated with varicella at the time of
employment unless contraindicated. Follow up appointment for one month vaccination will be scheduled
at Employee Health.
3. If the varicella vaccine is not administered the HCW is cleared with restrictions.
Restrictions: Non-immune HCW cannot care for patients with infectious varicella zoster-chickenpox or
varicella zoster-shingles.
4. Follow up for existing HCWs: None.
5. Records of screening and/or vaccination will be maintained in the Employee Health HCW file.
III. Post-Exposure Evaluation and Prophylaxis
A. Blood Borne Pathogen Exposure: An exposure is defined as a percutaneous injury, mucous membrane contact,
or non-intact skin contact with of one of the following: amniotic fluid, blood, cerebrospinal fluid, pericardial
fluid, peritoneal fluid, pleural fluid, semen, synovial fluid, tissue, vaginal secretions, or other body fluids
containing visible blood. Any direct contact without barrier protection to concentrated HIV in a laboratory
facility is considered an exposure. Prolonged contact of several minutes with contaminated blood, tissue, or body
fluids involving a large area of intact skin is considered an exposure. Percutaneous injuries may include a
needlestick or a cut with a sharp object. Non-intact skin is chapped, abraded or afflicted with dermatitis. Human
bites and scratches may be included. In the absence of visible blood in the saliva, exposure to saliva from a
person infected with HIV is not considered a risk for HIV transmission. Exposure to tears, sweat, non-bloody
urine, or non-bloody feces does not require post-exposure follow up.
1. HIV
a. Immediate post-exposure measures:
1) Percutaneous injury:
a) Wash the wound with soap and water.
b) Antiseptics are not contra-indicated. However, there is no evidence that use of antiseptics for
wound care further reduces the risk of HIV transmission.
c) There is no evidence that expressing fluid by squeezing the wound further reduces the risk of
HIV transmission.
d) The application of caustic agents such as bleach is not recommended.
e) Injection of antiseptics or disinfectants into the wound is not recommended.
2) Non-intact skin exposure
a) Wash the area immediately with soap and water.
b) Antiseptics are not contra-indicated. However, there is no evidence that use of antiseptics for
wound care further reduces the risk of HIV transmission.
c) The application of caustic agents such as bleach is not recommended.
d) Injection of antiseptics or disinfectants into the wound is not recommended.
3) Mucous membrane exposure:
Irrigate copiously with tap water, sterile saline, or sterile water for 15 minutes.
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