Procedure for Medical Student Exposure to Infectious and Environmental Hazards
LSUHS School of Medicine seeks to prevent and mitigate medical student and visiting medical student exposure to infectious and environmental hazards. Medical students and visiting medical students who are exposed to an infectious or environmental hazard (e.g., punctured with a used needle or contaminated sharp, splashed with blood or body fluids to mucous membranes, come in contact with blood or body fluids to non-intact skin) should adhere to the procedure outlined below.
Procedure for Care and Treatment after Exposure
Drug prophylaxis following a high-risk exposure is time sensitive, therefore you must immediately seek help from the appropriate hospital department.
Report to LSUHS Occupational/Student Health
After Hours, Weekends, and Holidays
Report to Ochsner LSU Health Emergency Room
- Treat the exposure site:
• Percutaneous Stick:
o Bleed the Wound; use soap and water to wash areas exposed to potentially infectious fluids as soon as possible after exposure.
Puncture wounds can be cleaned with an alcohol-based cleanser, chloroxylenol, or chlorhexidine.
• Mucous Membrane Exposure with blood:
o Immediately flush the area with water (for eye splashes flush with water or saline solution for a minimum of fifteen minutes)
- Student should notify his/her supervisor/clinical preceptor of the exposure
- Supervisor/Clinical Preceptor will immediately complete an LSUHS ON-THE-JOB INJURY REPORT, as appropriate to the situation. On-the-Job Injury Reporting (Administrative Directive 7.2)
- Supervisor/Clinical Preceptor will ensure that the following steps are taken:
a. A blood sample from the patient who is the source should be obtained. Two red top tubes are needed from the source (neither a doctor’s order nor the patient’s permission is needed).
b. The blood sample test tubes should be labeled with the patient (source) information. The tubes and the LSUHS ON-THE-JOB INJURY REPORT signed by a supervisor should be brought to Occupational/Student Health
- Student reports to Occupational/Student Health (3rd Floor A Bldg.) or Ochsner LSU Health ER for initial lab work and medical treatment. Medical treatment may include, but is not limited to post-exposure prophylaxis, stitches for a laceration or irrigation of eyes after a splash depending on the exposure type, injury and source patient information.
- The exposed student should return to the Occupational/Student Health when notified by email, usually by the next business day for follow up (the initial test results should be available at that time).
Exposure at an Outside Facility
- Follow procedures consistent with the institution and report to nearest emergency room if applicable.
- Student or supervisor/clinical preceptor calls Occupational/Student Health (318-626- 0663) regarding incident (student name, date, and time) within 24 hours. Fill out an LSUHS ON-THE-JOB INJURY REPORT, as appropriate to the situation
- An Occupational/Student Health representative will work with outside agency to plan follow-up care.
Students are not financially responsible for any lab tests ordered for proper treatment of the incident. If exposure occurs outside of the LSUHSC-S or Ochsner LSU Health facility, the student may be billed for cost incurred. LSUHSC-S will cover the cost of post-exposure chemoprophylaxis for LSUHSC-S medical students exposed to HIV blood (needlesticks, etc.). This is a four-week course of post-exposure therapy involving Truvada and Isentress (expanded regimen). Such treatment will be coordinated, including follow-up, through the Occupational/Student Health Clinic.
For visiting students rotating at LSUHSC-S, the student will be responsible for the costs of any care, testing, and counseling. Charges/expenses associated with the testing and treatment may be covered by the student's personal health insurance plan.
Effects on Medical Student Learning Activities
Students with an infectious or environmental disease requiring medical attention are excused from training duties to seek medical care. Students infected with, and in some cases exposed to, certain infectious diseases of high importance in health care settings are expected to adhere to work restrictions suggested in the Centers for Disease Control and Prevention Personnel Health Guidelines, 1998. Students with conditions requiring testing or treatment should consult with Occupational/Student Health or their preferred medical provider prior to returning to duty. See full Student Exposure Policy for details.