Universal Protocol for Invasive Procedures in HIV-HCV Cases

Protocol for Invasive Procedures in HIV/HBSAG/HCV Seropositive Cases

The following protocol has to be followed strictly to prevent occupational exposure :

1. It is mandatory that all personnel handling patients with seropositive reports are aware of the patient’s status and know all the procedures to be followed as listed below (SIC must ensure the above and indicate on patient record by yellow and red stickers)
2. The bed to be covered with disposable sheets (incident for AIDS kit from materials department). If soiling of hospital linen occurs, soak it in 10% fresh bleaching powder overnight and send for hot laundry.
3. A bit plastic bin with double plastic cover lining to be placed near the bed. Once it is 3/4 th full, send it for incineration.
4. All parenteral material (Syringes, Catheter, IV lines, Gloves) used for the patient to be discarded into bin.
5. Use Cidex cans to be used for discarding sharp objects. Once it is 3/4 th full, fill it with Cidex and keep it overnight and send for incineration.
6. Double gloves to be worn while starting IV line, Throat secretion suction, drawing blood.
7. All samples sent to lab must be put in Biohazard Polythene cover with red/yellow sticker. Gloves to be worn by ward boy while transporting samples. Request slip must never be soiled with sample.
8. Bed to be covered with absorbent padded sheets (indent from materials department) if bleeding, or ooze is anticipated. If bed is soiled then it is wiped with 5% Sodium Hypochlorite and Carbolised.
9. After patient is discharged, ensure room is sterilized as per room sterilization protocol.
10. All instruments used for the patient must be washed, soaked in Cidex overnight, washed with detergent and sterilized.
11. All excretion and secretion to be flushed. Container to be disinfected with Sodium Hypochlorite, washed with detergent before reuse.
12. Cidex (2 cans of monir case, 4 if major), Lysol (1 can), Sodium Hypochlorite — 5%
13. Gloves, masks and eye shields
14. Big buckets with plastic cover lining
15. Big and small plastic bags
16. Used Cidex cans for putting in needles.
17. AIDS disposable kit (2 kits if minor case, 6 if major case)

Seropositive cases

Sample collection, radiology department and nuclear medicine

The following protocols have to be followed strictly to prevent occupational exposure :

1. It is mandatory that all personnel handling patients with seropositive reports are aware of the patient’s status and know all the procedures to be followed as listed below. Sister in charge must ensure the above and indicate on patient record by red and yellow stickers.
2. A closed plastic bin with double plastic cover lining to be placed in the room. Contents to be sent for incineration once procedures are over.
3. All potential material (syringes, catheter, IV lines, gloves) used for the patient to be discarded into bin.
4. Used Cidex to be used for discarding sharp objects. Once it is 3/4 th full, fill it with Cidex and keep it overnight and send it for incineration.
5. Double gloves to be worn for any procedure.
6. All samples sent to lab must be put in biohazard polythene cover either red/ yellow sticker. Gloves to be worn by ward boy while transporting samples. Request slip must never be soiled with the sample.
7. Bed to be covered with absorbent padded sheets (indent from materials department) if bleeding, or ooze is anticipated. If bed is soiled then it is wiped with 5% sodium hypochlorite and carbonized.
8. All instruments used for the patient must be washed, soaked in cidex overnight washed with detergent and sterilized.
9. All excretion and secretion to be flushed. Container to be disinfected with sodium hydrochloride, washed with detergent before reuse.
10. In all cases of exposure to blood or body fluids the flowing procedures should be followed :

• Encourage the affected area of skin to bleed for the few seconds
• Do not suck the puncture site
• Rinse immediately under running water and wash with soap and water and then alcoholic/ chlorhexidine solution.

If the spillage of the blood and body fluids has occurred on intact skin then the effected area should be rinsed immediately under running water and washed with soap and water. Do not scrub. Rinse and dry. Exposed mucous membrane or conjunctive should be irrigated immediately with copious amounts of water using either running tap water or an eyewash bottle.