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Emergency Department Evaluations of Non-Percutaneous Blood or Body Fluid Exposures during Cardiopulmonary Resuscitation

Published online by Cambridge University Press:  28 June 2012

Roland C. Merchant ,
Jeremy B. Katzen ,
Kenneth H. Mayer  and
Bruce M. Becker
Roland C. Merchant*
Affiliation:
Department of Emergency Medicine, Brown Medical School, Providence, Rhode Island, USA Department of Community Health, Brown Medical School, Providence, Rhode Island, USA
Jeremy B. Katzen
Affiliation:
Department of Emergency Medicine, Brown Medical School, Providence, Rhode Island, USA
Kenneth H. Mayer
Affiliation:
Department of Community Health, Brown Medical School, Providence, Rhode Island, USA Department of Medicine, Division of Infectious Diseases, Brown Medical School, Providence, Rhode Island, USA
Bruce M. Becker
Affiliation:
Department of Emergency Medicine, Brown Medical School, Providence, Rhode Island, USA Department of Community Health, Brown Medical School, Providence, Rhode Island, USA
*
Roland C. Merchant, MD, MPH Department of Emergency MedicineRhode Island Hospital593 Eddy StreetProvidence, RIUSA02903 E-mail: rmerchant@lifespan.org
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Abstract

Introduction:

The demography of healthcare workers (HCWs) and non- HCWs seeking medical care at emergency departments after a non-percutaneous potential exposure to human immunodeficiency virus (HIV) duringcardiopulmonary resuscitation (CPR), the types and body locations of their exposures, the time elapsed from exposure to emergency department presentation, and usage of HIV-post-exposure prophylaxis (PEP) for these exposures are described.

Methods:

A retrospective study of emergency department patients who were exposed to blood or body fluids during CPR in Rhode Island from January 1995–June 2001 was performed.The demography, characteristics of the exposure, and HIV-PEP usage for these patients were compared, and the elapsed time from exposure to evaluation inthe emergency department was calculated.

Results:

Of the 39 patients exposed to non-percutaneous blood or body fluid during CPR, 22 were healthcareworkers (HCWs) and 17 were non-HCWs. Thirty-four patients sustained mucous membrane exposures. Most of the patients (69.2%) were exposed to saliva or sputum (p <0.001), experienced a mouth exposure (71.8%; p <0.0001) and presented to the emergency department within one day of their exposure (84.4%; p <0.0001).Three HCWs and no non-HCWs were offered HIV-PEP for their CPR exposure. Of the three HCWs offered PEP, two actually received it.

Conclusions:

Nearly half of the patients who presented with non-percutaneous exposures acquired during CPR were not HCWs. Most of the exposures were to saliva or sputum and occurred on their mucous membranes. Continuing education programs on maintaining universal precautions to prevent blood or body fluid exposures and appreciating the benign nature of most non-percutaneous exposures possible during CPR are needed.

Keywords

blood-borne pathogenscardiopulmonary resuscitationemergency serviceshuman immunodeficiency virus (HIV)prophylaxisresuscitation
Type
Original Report
Information
Prehospital and Disaster Medicine , Volume 22 , Issue 4 , August 2007 , pp. 330 - 334
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2007

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