Know different problems faced by health care workers who are either carriers or get exposed to different Bacteria/viruses.

Explanation

The discussion will focus on HIV  & HBV exposure, Meningococcal exposure, Needlestick injury, MRSA & VRE carrier states.

All of us should be immunized against Hepatitis B.

HIV does not preclude a doctor or nurse to discontinue their job.

A needlestick injury must be carefully evaluated. If a needle contaminated with a patient,s body fluid enters a healthcare worker, the employer is responsible for all the expenses. Anti HIV medications MUST be offered within 4 hours. SOLID needles (eg lance for accucheck) have not been shown to transmit HIV. At least 2 anti HIV drugs should be offered. If the source patient has been on Zidovudine, the victim should also be offered a 3rd anti HIV drug as well. These should be taken for 1 month & victim to be sexually protective for 6 months. The source & patient needs to be checked immediately and in 6 weeks, 12 wks & 6 mo- and the source patient has no right to refuse but we generally get a consent form signed.

There was recently a question on the risk of HIV transmission - it is 1 in 200 encounters. The risk of Hepatitis B on the other hand is 1 in 20 encounters. This is also called the transmission rate.

Meningococcal prophylaxis must be given to close contacts of the patient with meningococcal meningitis. The drug of choice is Rifampin for 2 days. A good alternative is Ciprofloxacin - single dose but this should be avoided in patients under the age of 17 due to cartilage deposition.

MRSA & VRE carriage states .

Mupirocin cream is good for MRSA eradication from the nostril.

Use Contact Precautions when caring for patients with MRSA. Contact Precautions mean:

Whenever possible, patients with MRSA will have a single room or will share a room only with someone else who also has MRSA.

Healthcare providers will put on gloves and wear a gown over their clothing while taking care of patients with MRSA.

Visitors may also be asked to wear a gown and gloves.

When leaving the room, hospital providers and visitors remove their gown and gloves and clean their hands.

Patients on Contact Precautions are asked to stay in their hospital rooms as much as possible. They should not go to common areas, such as the gift shop or cafeteria. They may go to other areas of the hospital for treatments and tests.

• May test some patients to see if they have MRSA on their skin. This test involves rubbing a cotton-tipped swab in the patient’s nostrils or on the skin.

 

 

Clostridium difficile has become the COMMONEST nosocomial infection. Its spores transmit the disease and do not get killed by the alcohol based hand sanitizers placed all along the hospital.