Blood and Body Fluid Pathogen Exposure Protocol and Policy

		NYCPM/FCNY	METROPOLITAN	HARLEM	LINCOLN	MORISANIA	OTHER EXTERNAL PROGRAMAS
1	Render first aid and notify	Immediately wash area with water, do not "milk" part, and cover appropriately. Notify the attending. Attending will notify the unit.
2a	If the sharp was NOT contaminated with the Source's body fluid(s) before the injury	On-site Attending or NP will eval/care for hand wounds OR go directy to Metropolitan Hospital ED. Proceed to Steps 5-6.	Report to hospital ED for wound eval and care. Proceed to Steps 5-6.	Report to hospital ED for wound eval and care. Proceed to Steps 5-6.	Report to hospital ED for wound eval and care. Proceed to Steps 5-6.	Report to Lincoln Hospital ED for wound eval and care. Proceed to Steps 5-6.	Report to Hospital ER for wound eval and care. Proceed to Steps 5-6.
2b	If the sharp WAS contaminated by the Source’s body fluid(s) before the injury	The attending clinician must arrange College transportation to the ED in consultation with NYCPM Department of Safety and Security. If NYCPM Residents are available, they should be contacted to help facilitate the student’s progress at the ED. Proceed to Step 3. Note: For Other External Programs, report to Hospital ER for wound eval and care. Proceed to Steps 5-6.
3	By history, if the Source is HIV, HBV, or HCV POSITIVE DO NOT DISMISS PATIENT	Within 2 hours of injury, report (w/Source) to Metropolitan Hospital ED for possible postexposure prophylaxis (PEP). Also, proceed to Steps 5-6.		Within 2 hours of injury, report (w/Source) to Harlem Hospital ED for possible post-exposure prophylaxis (PEP). Also, proceed to Steps 5-6.	Within 2 hours of injury, report (w/Source) to Lincoln Hospital ED for possible PEP or see triage nurse in ED. Also, proceed to Steps 5-6.		Within 2 hours of injury, report (w/Source) to Hospital ER for possible PEP or see triage nurse in ED. Also, proceed to Steps 5-6.
4	If Source's HIV or HCV status is UNKNOWN DO NOT DISMISS PATIENT	Attending of unit supervisor will approach Source for consent to perform rapid HIV testing and/or serologic testing for HIV, HBV and HCV. If consent given, sample obtained by medical technologist or NP. If consent is NOT GIVEN within 2 hours of injury, report (with Source) to Metropolitan Hospital for possible PEP or see Triage Nurse in ED. If rapid HIV test of SOURCE is POSITIVE Proceed to Step 3.	Attending of unit supervisor will approach Source for consent to perform rapid HIV testing and/or serologic testing for HIV, HBV and HCV. If consent given, sample obtained by medical technologist or NP. If consent is NOT GIVEN within 2 hours of injury, report (with Source) to Metropolitan Hospital for possible PEP or see Triage Nurse in ED. If rapid HIV test of SOURCE is POSITIVE Proceed to Step 3.
5	Incident Report	An "Incident Report must be filed with NYCPM/FCNY Dept. of Safety and Security ASAP in the event of a BBFE. Student must send the "Incident Report" to Michael Trepal, DPM via email mtrepal@touro.edu and a copy to Victor Politi, MD, victor.politi@touro.edu	Incident report should be completed. Students are required to send the ""Incident Report"" to Michael J. Trepal, DPM, Vice President for Academic Affairs and Dean, NYCPM via email to mtrepal@touro.edu. A blank copy of the “Incident Report” is located on Canvas in the 3rd &4th year credentialing folder. All facilities will also require their own reporting and treatment. All facilities will also require their own reporting and treatment.
6	Treatment Refusal Form	If student refuses treatment, a “Refusal of Treatment Form” must be completed by attending clinician and students. *FILE REPORT	All facilities will also require their own reporting and treatment.
7	Counseling and Follow-up	As per the recommendations of the hospital ED for follow-up, the student will be referred by the triage nurse to go to the NYCHHC ID Department or their primary care physician for counseling and follow-up. The student will inform the VP of Academic Affairs at NYCPM of incident, follow-up and recommendations and submit a copy of the incident report and discharge summary from local hospitals and/or Externship facilities. *FILE REPORT: An “Incident Report” will be sent to: Asst. to the Dean for Clinical Clerkships & Affiliations who will upload to SharePoint and keep for 5 years. Notifications will be sent to: Medical Director, VP of Academic Affairs & Dean, COO and VP for Administration, Dean of Clinical Ed, Dean of Student Services, FCNY Clinic Administrator, Dean of Academic Affairs of Outcomes, and Director of Safety and Security.