CICM SAQ 2015.1 Q5

Immediate Response:

• Stop the procedure
• Ensure patient is safe
• Takeover / delegate patient management as required

Further response:

• Wash the registrar’s wound immediately with soap and water
• Express any blood from the wound
• Initiate injury-reporting system used in the workplace
• Patient may need to be consented and then tested for HIV, hepatitis B, Hepatitis C
• Refer registrar to designated treatment facility: Emergency Department / Infectious Disease Physician / 
Immunology as per hospital protocol
• With consent, registrar to be tested immediately and confidentially for HIV, hepatitis B and C
• Document the exposure in detail for your own record and for the employer
• If the patient is HIV positive, post exposure prophylaxis needs to be started within two hours of the 
exposure.

• For possible Hepatitis C exposure, no treatment is recommended but advice must be obtained 
from Infectious Disease Specialist
• If the source patient tests positive for HIV, hepatitis B, hepatitis C, get post-exposure prophylaxis in 
accordance with CDC guidelines and as per recommendations from Infectious Disease Specialist or other 
expert.
• Registrar to have follow up with post exposure testing
• Advise re: taking precautions (including safe sex) to prevent exposing others until follow up testing is 
complete.
• If exposed to blood borne pathogen, he/she should not donate blood for six months until cleared

Counselling:

• While definitive testing is essential, counsel the registrar that the risk factors for infection are: deep injury, visible blood on devices, and needle placement in a vein or artery, lower risk with solid suture needle.

Related to procedure:

• Review of registrar’s technique, equipment used, unit policy for procedural training, assessment of competency, etc.