CLINICAL LAB SCIENEC

CHAPTER 6: INTRODUCTION TO INFECTION CONTROL 127
unexpected situation where a release of blood or toxins occurs accidentally and
persons are exposed. A physician makes the determination regarding an actual
exposure. If damaged skin comes in contact with body fluids or if the employees
receives an accidental needle stick from a contaminated needle or a cut from
contaminated instruments, an exposure incident has occurred. An exposure to
airborne pathogens most often occurs when an employee is exposed to a patient
who is later diagnosed as having active TB.
An exposure may involve a number of products, but primarily either biohazardous
materials or toxic chemicals for the purposes of this section. Any
time a layperson or medical worker comes in direct contact with body fluids
or provides treatment to a patient later found to have an infectious disease, the
status of the person exposed should be assessed. Any other worker who was
possibly exposed to the infected patient should also undergo a health assessment,
especially if contact with blood and body fluids may have occurred. This
assessment might require only counseling but may include preventive immunization
or the collection of a blood sample to determine baseline laboratory
values. Prophylactic treatment is sometimes initiated where a high likelihood
of exposure has occurred. Postexposure prophylaxis (PEP) may be initiated
in which treatment is begun to prevent replication of viruses such as HIV, or
gamma globulin–containing antibodies against an organism such as HBV are
administered.
Usually at 2 weeks following an exposure incident, a second blood sample
may be collected to determine if any changes have occurred. The first sample,
drawn immediately following the incident, is called the baseline sample
or the acute sample. Blood is drawn aseptically and is separated into blood
cells and plasma or serum (liquid portion of the blood). The acute specimen
should be negative for antibodies against the suspected organism if the blood
sample is drawn almost immediately after exposure and the person has had
no prior exposure or immunization to the particular disease organism. The
sample collected 2 weeks after the acute sample is called the convalescent
sample. If the particular antibody is negative in both samples, no infection
was contracted. If the first sample is negative, and the second positive, more
than likely an exposure has occurred that has led to infection. Positive results
from these samples will confirm an exposure and subsequent contraction of
a disease.
Exposure through Spills of Biohazardous and Toxic Materials
When biohazardous materials or toxic chemicals are spilled, it is important to
observe the following procedures to protect others who may enter the area.
Warning signs should be placed as necessary in areas where foot traffic occurs,
before beginning the clean-up process described below.
1. An absorbent material or a specially designed gel should be used to cover the
entire spill. The custodial staff will be responsible for the proper removal of
the spills and will provide thorough cleaning of the area. Wastes should be
removed to an area for storage until disposed of properly.
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