A first-year internal medicine resident sustains a deep, bleeding needlestick injury to their index finger while drawing arterial blood from a patient with known, poorly controlled HIV infection. Arrange the following steps in the most appropriate chronological sequence for managing this occupational exposure.
- 1Wash the puncture site thoroughly with soap and water
- 2Report the incident to the occupational health department
- 3Draw blood from the exposed resident for baseline serologic testing
- 4Initiate a three-drug antiretroviral post-exposure prophylaxis (PEP) regimen
Cevap
The correct chronological sequence is: 1) Wash the puncture site, 2) Report the incident to occupational health, 3) Draw baseline blood for serology, and 4) Initiate the post-exposure prophylaxis regimen.
The standard sequence for managing an occupational exposure to bloodborne pathogens begins with immediate local first aid (washing with soap and water) to reduce the viral inoculum. This is followed by reporting the incident to occupational health to activate institutional protocols. Next, baseline serology and safety labs are drawn from the exposed healthcare worker. Finally, a three-drug antiretroviral PEP regimen is initiated as soon as possible, ideally within 1 to 2 hours of the exposure.
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Occupational HIV exposure management sequence
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