HOUSE STAFF POLICIES AND PROCEDURES MANUAL

SECTION 14: INFECTION CONTROL

A. NEEDLE STICKS AND OTHER BLOOD/BODY FLUID INJURIES

1. Always observe Standard Precautions.
2. If you have a significant exposure to blood or other body fluids (e.g., needle stick, cut), immediately clean the wound with soap and water.
3. Exposed oral and nasal mucosa should be decontaminated by vigorously flushing with water. Exposed eyes should be irrigated with clean water or sterile saline.
4. Follow the protocol of the hospital in which the incident occurred to the fullest including all follow-up (through the hospital's Employee Health Service). It is especially important that you report your exposure to the hospital’s Employee Health Service as soon as possible so that a timely evaluation can be performed. If prophylactic medications are indicated, it is recommended they be initiated as soon as possible after the exposure.
5. In addition to #4,call/page the Hospital Epidemiologist (or ID service if Hospital Epidemiologist is not available) for consultation (see list below).
6. Acute serology should be drawn at the Employee Health Service to establish your baseline antibody titers to hepatitis B virus (if you have not previously been determined to be HBsAb positive [immune to Hepatitis B]) and, if indicated, to HIV and/or Hepatitis C Virus [HCV] (if the source patient is HIV-positive or HCV-positive).
7. Depending on the results of your serology and the baseline serology of the source patient (from whom the exposure occurred), you may need follow-up serologies and additional testing as per the hospital protocol where the injury occurred.
8. If the source patient is HIV-infected, the administration of post-exposure prophylaxis (PEP or "prophylactic” antiretroviral medications) to decrease the risk of patient to health care worker transmission should be strongly considered. Medications may be initiated pending results of HIV serology on the source patient. If used, these medications should be taken as soon as possible after the needlestick injury. The hospitals have protocols and will counsel you and give advice as needed. PEP regimens are complicated; therefore be sure that the individual who manages your exposure consults with the Hospital Epidemiologist. Again, call/page the Hospital Epidemiologist or ID service if you have any questions about management of the needlestick or other occupational exposure.
9. The following list of specific areas and/or individuals should be contacted at the facility in which the exposure occurs:
   

GRADY MEMORIAL HOSPITAL AND AFFILIATED SITES:

Daytime hours, Monday thru Friday:

Employee Health Service call 404-616-7849 (STIX)

or 404-616-4600

After hours and on weekends: Needlestick Hotline

Call 404-616-7849 (STIX)

Dr. Henry Blumberg, Hospital Epidemiologist; Division of Infectious Diseases

Office: 404-616-6145; Pager: 404-686-5500; ID# 15029; Home: 404-377-5095

Dr. Susan Ray, Associate Hospital Epidemiologist, Division of Infectious Diseases

Office: 404-616-6139, Pager: 404-837-8946; Home: 404-373-8537

Dr. Carlos Diaz Granados, M.D., Assistant Hospital Epidemiologist, Division of Infectious Diseases

Office: 404-616-4634, Pager 404-278-8774;

If you are unable to reach any of the above individuals, ask the paging operator at 404-616-4307 to contact the Infectious Diseases Attending on call; if not available contact the Infectious Diseases Fellow on call.

VA MEDICAL CENTER:

Daytime hours, Monday thru Friday:

Infection Control/Employee Health,

Room 611, Debbie Hawkins RN: 404-321-6111, Ext. 6471

After hours and on weekends: Emergency Room 404-321-6111, Ext. 6640

Dr. Robert Gaynes, Division of Infectious Diseases

Office: 404-321-6111, ext. 17508; Pager: Pager 404-485-7918

Dr. David Rimland, Division of Infectious Diseases

Office: 404-321-6111, ext. 16165; Pager: 404-722-3122; Home: 770-393-8951

Abeer Moanna, MD, Division of Infectious Diseases

Office: 404-321-6111 ext 12093. Pager 404-225-0576 Home: 404-846-6362

If you are unable to reach any of the above individuals, ask the paging operator at 404-321-6111 to contact the Infectious Diseases Attending on call; if not available contact the Infectious Diseases Fellow on call.

CRAWFORD LONG HOSPITAL OF EMORY UNIVERSITY:

Daytime hours, Monday thru Friday ( 7 am to 4 pm):

Employee Health Service--Orr Bldg 6 th floor, 478 Peachtree St. 404-686-2352

After hours, and on weekends:

Page Administrative Nursing Supervisor (PIC#11917)

Dr. James Steinberg, Hospital Epidemiologist, Division of Infectious Diseases

Office: 404-686-8910; Pager: 404-686-5500, ID# 15770; Home: 404-876-4717

Dr. Carolyn Gould, Associate Hospital Epidemiologist, Division of Infectious Diseases

Office, 404-686-1564, Pager 404-686-5500, ID# 15897;

If you are unable to reach any of the above individuals, ask the paging operator at 404-686-1000 to contact the Infectious Diseases Attending on call; if not available, contact the Infectious Diseases Fellow on call by dialing 404-686-5500, PIC# 50260.

EMORY UNIVERSITY HOSPITAL

Daytime hours, Monday thru Friday ( 7 am to 4 pm):

Employee Occupational Health Services, HB 53 Emory Hospital 404- 686-8587

After hours and on weekends:

Page Administrative Nursing Supervisor (PIC#13087)

Emergency Room 404-712-7100

Dr. Bruce Ribner, Hospital Epidemiologist, Emory University Hospital and Emory Division of Infectious Diseases

Office: 404-727-1580; Pager: 404-686-5500, PIC# 15326; Home: 404-417 0225

If you are unable to reach any of the above individuals, ask the paging operator at 404-727-4611 to contact the Infectious Diseases Attending on call; if not available, contact the Infectious Diseases Fellow on call.  

CHILDREN'S HEALTHCARE OF ATLANTA (EGLESTON OR SCOTTISH RITE)

Daytime hours, Monday thru Friday:

Employee Health, Digital Pager 1-800-682-4549 or Needlestick Hotline (ext 4444 at Egleston and ext 824444 at Scottish Rite)

After hours and on weekends: same as above.

Dr. Harry Keyserling, Pediatric Infectious Diseases

Office: 404-727-5642; Pager 404-686-5500, ID# PIC 17123; Home: 404-377-8535

If you are unable to contact any of the above individuals, ask the paging operator at

404-325-6000 to page the Infectious Diseases Fellow on call.

10. Any of the following physicians may be contacted for assistance and additional advice, but the injury should first be reported as outlined in #9, above, for immediate help.

Henry M. Blumberg, M.D., Grady Memorial Hospital, 404-616-6145

Carlos DiazGranados, M.D., Grady Memorial Hospital, 404-616-4634

Harry Keyserling, M.D., Egleston Hospital, 404-727-5642

Susan M. Ray, M.D., Grady Memorial Hospital, 404-616-6139

David Rimland, M.D., VA Medical Center, 404-321-6111, Ext. 16165

Robert Gaynes, M.D., VA Medical Center, 404-321-6111 Ext 17508

Carolyn Gould, M.D., M.Sc., Crawford Long Hospital, 404-686-1564

Bruce Ribner, M.D., M.P.H. Emory University Hospital, 404-727-1580

J. William Eley, M.D., MPH, Medical School Administration, 404-727-5655

James Steinberg, M.D., Crawford Long Hospital, 404-686-8909

11. The cost of the follow-up and necessary medications will be borne by Emory University Affiliated Hospitals.

12. For medical students, all incidents and follow-up occurring at a hospital should be reported within 4 days to the Office of Medical Education and Student Affairs at Emory University (404-727-5655), i.e., incident report and follow-up plans.

 

 

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