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Section 14: Infection Control

NEEDLESTICKS AND OTHER BLOOD/BODY FLUID EXPOSURES

  1. Always observe Standard Precautions.
  2. If you have a significant exposure to blood or other body fluids (e.g., needlestick, 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). If you are uncertain of the hospital’s post-exposure protocol, you may call the WHSC Needlestick Hotline for guidance (404-727-4136).  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. 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].
  6. 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.
  7. 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 exposure.  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.  Call/page the Hospital Epidemiologist or ID service if you have any questions about management of the needlestick or other occupational exposure.
  8. The following list of specific areas and/or individuals should be contacted at the facility in which the exposure occurs:

    1. GRADY MEMORIAL HOSPITAL AND AFFILIATED SITES:

      Daytime hours, Monday thru Friday:
      Employee Health & Wellness Services 
      		 call 404-616-7849 (STIX)
        or 404-616-4600
      After hours and on weekends:  
      Needlestick Hotline Call 404-616-7849 (STIX)


      Dr. Susan Ray, Hospital Epidemiologist, Division of Infectious Diseases
      Office: 404-251-8712, Pager: 404-837-8946; Home: 404-373-8537

      Dr. Henry Blumberg, Physician, Division of Infectious Diseases
      Office: 404-727-5096; Pager: 404-686-5500, ID#15029; Home: 404-377-5095

      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.

      EMORY UNIVERSITY HOSPITAL MIDTOWN:

      Daytime hours, Monday thru Friday (7 am to 4 pm):
      Employee Health Service  
      Orr Bldg 6th floor, 478 Peachtree St  404-686-2352
      After hours and on weekends:  
      Page Administrative Nursing Supervisor (PIC#11917


      Dr. Jesse Jacob, Associate Hospital Epidemiologist, Division of Infectious Diseases
      Office: 404-686-1564; Pager: 404-686-5500, ID# 16623; Mobile: 404 402-5110,

      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, D219 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
      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.

  9. 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.
    1. Henry M. Blumberg, M.D., Grady Memorial Hospital, 404-727-5096
    2. Harry Keyserling, M.D., Egleston Hospital, 404-727-5642
    3. Susan M. Ray, M.D., Grady Memorial Hospital, 404-251-8712
    4. David Rimland, M.D., VA Medical Center, 404-321-6111, Ext. 16165
    5. Robert Gaynes, M.D., VA Medical Center, 404-321-6111 Ext 17508
    6. Jesse Jacob, M.D., Emory University Hospital Midtown, 404-686-1564
    7. Carolyn Gould, M.D., M.Sc., Emory University Hospital Midtown, 404-686-1564
    8. Bruce Ribner, M.D., M.P.H. Emory University Hospital, 404-727-1580
    9. James R. Zaidan, MD, Graduate Medical Education, 404-727-5658
  10. The cost of the follow-up and necessary medications will be borne by Emory University Affiliated Hospitals.
Grady Injury Flowchart 

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