Emergency department evaluations of non-percutaneous blood or body fluid exposures during cardiopulmonary resuscitation.
BACKGROUND
The demography of healthcare workers (HCWs) and non-HCWs seeking medical care at emergency departments after a non-percutaneous potential exposure to human immunodeficiency virus (HIV) during cardiopulmonary resuscitation (CPR), the types and body locations of their exposures, the time elapsed from exposure to emergency department presentation, and usage of HIV-post-exposure prophylaxis (PEP) for these exposures are described.


METHODS
A retrospective study of emergency department patients who were exposed to blood or body fluids during CPR in Rhode Island from January 1995-June 2001 was performed. The demography, characteristics of the exposure, and HIV-PEP usage for these patients were compared, and the elapsed time from exposure to evaluation in the emergency department was calculated.


RESULTS
Of the 39 patients exposed to non-percutaneous blood or body fluid during CPR, 22 were healthcare workers (HCWs) and 17 were non-HCWs. Thirty-four patients sustained mucous membrane exposures. Most of the patients (69.2%) were exposed to saliva or sputum (p <0.001), experienced a mouth exposure (71.8%; p <0.0001) and presented to the emergency department within one day of their exposure (84.4%; p <0.0001). Three HCWs and no non-HCWs were offered HIV-PEP for their CPR exposure. Of the three HCWs offered PEP, two actually received it.


CONCLUSIONS
Nearly half of the patients who presented with non-percutaneous exposures acquired during CPR were not HCWs. Most of the exposures were to saliva or sputum and occurred on their mucous membranes. Continuing education programs on maintaining universal precautions to prevent blood or body fluid exposures and appreciating the benign nature of most non-percutaneous exposures possible during CPR are needed.
Merchant
Roland C
RC
Department of Emergency Medicine, Brown Medical School, Providence, Rhode Island, USA. rmerchant@lifespan.org
Katzen
Jeremy B
JB
Mayer
Kenneth H
KH
Becker
Bruce M
BM
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D017848:Blood-Borne Pathogens; D001826:Body Fluids / Q000821:virology*; D016887:Cardiopulmonary Resuscitation; D018890:Chemoprevention / Q000706:statistics & numerical data*; D017723:Drug Utilization Review; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D005392:First Aid / Q000706:statistics & numerical data; D015658:HIV Infections / Q000209:etiology / Q000517:prevention & control* / Q000635:transmission; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012237:Rhode Island; D012463:Saliva / Q000821:virology; D013183:Sputum / Q000821:virology; D016635:Universal Precautions / Q000379:methods
D019380:Anti-HIV Agents