HIV-PEP HELPLINE FOR HEALTH PROFFESSIONALS
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WE NEED SOME ONE TO GUIDE US THIS IS FOGSI EFFORT SINCE 2008...THE FIRST HELP LINE OF ITS KIND IN THE WORLS
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HIV-PEP HELPLINE FOR HEALTH PROFFESSIONALS
- 1. FOGSI HIV PEP HELPLINE Dr.Narendra Malhotra FOGSI coordinator for PEP Helpline Dr. Alok Vashishtha Consultant in Infectious Diseases Haridwar
- 2. What is Post exposure prophylaxis for HIV ?
- 3. Exposure OCCUPATIONAL EXPOSURE that may place a worker at risk of HIV infection is a percutaneous injury ,contact of mucous membrane or contact of skin (especially when the skin is chapped, abraded or affected with dermatitis or the contact is prolonged or involves an extensive area ) with blood tissue or other body fluids to which universal precautions apply. Institute of Infectious Diseases
- 4. Why this helpline ?
- 5. Why this helpline ? The needle stick injury can not only lead to some life threatening blood borne infections as well as have severe emotional impact on health care personnel. It is an medical emergency and can happen anywhere anytime FOGSI initiative is first of its kind in world Institute of Infectious Diseases
- 6. What is the extent of the problem ? Survey of 428 HCW in India - 343 (80%) had 1 PI in past 1 year (IJMR, April,2010) In USA there are 57 documented cases of health care workers contracting HIV from exposures; 137 other possible cases (NEJM 2003;348:826) Institute of Infectious Diseases
- 8. Rationale of PEP Information about primary HIV infection indicate that systemic infection does not occur immediately leaving a brief period within ‘window of opportunity’ during which post exposure antiretroviral intervention may modify viral replicaiton Institute of Infectious Diseases
- 9. Principle behind administering PEP Surface ligands of dendritic cells of skin or mucous membrane CD4 CELL Institute of Infectious Diseases
- 10. WHAT TO DO ON EXPOSURE It is a medical emergency Do not panic Institute of Infectious Diseases
- 11. WHAT NEXT REPORT PROMPTLY PEP MUST START AT THE EARLIEST PREFERABLY WITHIN TWO HOURS MAY BE UPTO 72 HOURS Institute of Infectious Diseases
- 12. How to assess risk ? The exposure report (Each exposure is unique) • Date and time of exposure Accurate report: Minute to minute details are ideal Procedure details…what, where, how, with what device Exposure details...route, body substance involved, volume/duration of contact Information about source person and exposed person Exposure management details Institute of Infectious Diseases
- 13. Launch of HELPLINE International Conference of HIV and Women 16 November, 2008, Nagpur
- 15. How does HELPLINE work ?
- 16. How helpline works A call is received from an exposed health care worker by Dr Alok Vashishtha, Specialist in HIV/AIDS on his cell. He then follows following procedure: Details of exposure are taken A protocol is decided ARV drugs are made available (if required) Follow up is done as decided Have a team of resource persons for complex scenarios
- 17. How drugs are made available Have a memorandum of understanding with all companies making and marketing HIV drugs. Dr Alok Vashishtha have the mobile numbers of National Sales manager of all companies in field of HIV therapy. Their pan India sales network of about 2500 executives is used to locate the pharmacy catering these drugs. Address is given to the exposed health care provider
- 19. Type of calls Call from around all states of India Call from Asia, Africa, Europe and USA. Problem phone calls (General query about HIV/AIDS) Special kind of exposures Missed calls Stigma calls For locating a OBGYN
- 20. Conclusions Health care workers put themselves at risk in their work Prevention of exposures is critical PEP can be useful intervention Management of occupational exposure is complex Expert consultation should be sought Finally Awareness of Universal precautions and PEP options: - allay fears of caring for HIV infected persons - reduced stigma and discrimination - better care of PLHIV Institute of Infectious Diseases
- 21. HELP LINE TEAM Dr. Narendra Malhotra Dr. C.N. Purandare Dr. Laxmi Shrikhande Dr .Alok Vashistha ACKNOWLEDGEMENTS All FOGSI Members www.fogsi.org
- 22. Prevention is better than cure Institute of Infectious Diseases
- 23. Thank You for your kind attention Institute of Infectious Diseases Nirmal Medical Foundation, Hardwar Institute of Infectious Diseases
Notas do Editor
- {"12":"It is important to collect and record information about the exposure on an exposure report, and to maintain the confidentiality of both the worker and the source patient. An exposure report should include the date and time that the exposure occurred, as well as details of what procedure was being performed, where, how, and what device (if any) was involved. If a device was involved, OSHA requires that the brand and manufacturer of the device be recorded. Details such as the route of exposure, body substance involved, and volume or duration of contact also should be included. Additionally, information about the source person and exposed person, if known, is critical, along with exposure management details, which will be discussed later.\n"}