BBP Incident Response & Reporting

Potential Exposure to BBP's

The CAHP Post-Exposure Prophylaxis (PEP) Program is designed to deal with accidental exposures to BBP.   Exposures can occur in either an academic setting such as a student lab or at a clinical rotation site.   All work carries risk and "accidents will happen".  When they do an immediate response will help to minimize your exposure risk.  Time is your biggest enemy but not too far behind can be panic.  

You'll need to know the answers to two basic questions when a potential exposure occurs:

  • What to do?
  • When to do it?

A timely and effective accident response involves having the necessary information readily available.  This is the reason behind the issuance of a college-wide PEP card.

PEP Cards

A pink wallet-size card is given to each student or faculty/staff that will enter an "at risk" training facility. Students are required to keep it on their person during the entire rotation period. Clinical student training supervisors should also be made aware of its contents.

The PEP card addresses the following exposure concerns:

  • First aid     
  • Instructor response
  • Department response
  • Contact information
  • Follow-up procedures

Common sense is your best ally in any potential exposure situation.  You should also follow the instructions on this card to the LETTER.  Give your card to your instructor if you are unable to read it.

Typical first aid measures by exposure site:

  1. Needle sticks, cuts, splashed area(s) - immediate washing with lots of soap and water.
  2. Eyes -  immediate rinsing with lots of water/saline at an eye wash station.

You will normally be referred to the training facility's trauma center (ER) for evaluation.  Students training at non-medical center facilities (e.g., doctor's office) should be directed to the nearest evaluation site affiliated with the practice.   

Treatment delays are to be completely avoided.  Contact the USA Medical Center (USAMC) on-call Infectious Disease (ID) physician specialist by calling (251) 471-7895 if you feel that you're questions or concerns are not being fully addressed.

Identify:

  • Yourself (full name).
  • Your location.
  • A phone number that you can be immediately reached at by ID personnel.

                       

Reporting Actions

Report any potential exposure... no matter how slight.  Not reporting an exposure incident because of potential embarrassment or being worried about getting in trouble is just plain ignorant.  Acquiring a "little HBV/HIV" infection from an unreported incident is akin to referring to someone as just a "little pregnant".  It doesn't make sense.

Notifications are to be made to your...

  1. On-site training supervisor - immediately after first aid is completed.
  2. Academic department - as soon as possible.
    • Normal working hours (8:00 AM - 5:00 PM) - training coordinator, department secretary.
    • After hours (night/weekend) - faculty/staff members listed on PEP card.

 

Program Enrollment

Mandatory requirements include student or employee blood work and an initial exposure evaluation by a PEP-trained provider. Accepting PEP drug therapy is voluntary. However, you are strongly encouraged to take PEP for an exposure to blood or body fluids from a known HIV infected person as soon as it is offered.

 

Baseline laboratory testing is outlined on the PEP wallet card.

  • Faculty/staff - Services are provided by a licensed health care professional  at no cost. You should report to USAMC Employee Health Office Monday through Friday 8:00 A.M. to 4:30 P.M. Report USAMC Emergency Room after 4:30 P.M. weekdays, weekends and on holidays.  
  • Students - All expenses incurred during the PEP medical evaluation, medication, and/or specialty care follow up are your responsibility. This is a major reason why you're required to have adequate health insurance coverage.

 

Exposure Accidents/Incident Investigation

Two forms must be filled out to ensure adequate exposure follow up and examination of preventative measures. 

  1. An USA Employee Accident/Incident Report Form is used to document a potential exposure event. Information gathered must include:
    • Type of first aid rendered
    • Name of exposed individual 
    • Location of incident 
    • Affected body site 
    • Route of exposure and how exposure occurred. 
    • Exposure source (patient, student, etc.).
    • On-site training supervisor initiating PEP protocol.
    • Medical personnel contacted during PEP initiation (name, date, time, etc.).
  2. An “Evaluation of Circumstances Surrounding an Exposure Incident Form (APPENDIX G of ECP) is also filled out, being maintained in the employee or student permanent record.

    The department chairperson performs the first-level review, followed by the Dean’s Office, then on to USA Director, Safety and Environmental Compliance, and finally to Human Resources- Risk Management.

  

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