Treatment after occupational exposure

  1, first aid treatment (1) stimulate bleeding: the emergency treatment of occupational exposure, as long as the situation allows, should perform first aid. If there is a wound on the skin, it should be repeatedly squeezed gently to squeeze out as much blood as possible from the injury.  (2) Soap and water to rinse the wound or stained skin. In case of mucous membrane exposure, apply saline (or water) to rinse repeatedly.  (3) Disinfection and dressing of the injured area: the wound should be disinfected by soaking or applying disinfectant solution (such as 75% alcohol, 2000mg/L sodium hypochlorite, 0.2%-0.5% iodophor, etc.) and dressing the wound.  2. Assessment (1) Monitor the source of exposure: If the source of exposure is unclear it should be tested immediately, preferably with a rapid test, as the results can be obtained within a few minutes. If the exposed source has symptoms of acute HIV syndrome, the viral load should be tested at the same time.  (2) Monitoring of occupationally exposed persons: Immediate serum sampling for backup, routine blood, blood biochemistry, liver and kidney function, hepatitis B and C viral markers, in order to monitor the toxic effects of drugs. If the source of exposure is drug addiction, prison inmates and other high-risk personnel, we recommend supplemental sampling for hepatitis C antibody, hepatitis B antibody and syphilis (RPR, TPPA).  (3) The exposure level and the severity of the source of HIV exposure should be determined by a professional physician in order to determine the drug prevention program after occupational exposure.  3. Medication precautions (1) Prophylactic medication should be started immediately after exposure, preferably within 1-2h after exposure. For exposed individuals with a high risk of infection, even if the interval is long (e.g., 1-2 weeks), prophylactic treatment should be considered; because even if infection cannot be prevented, early treatment is beneficial for acute HIV infection. Prophylactic dosing should be continued for 4 weeks.  (2) If subjective or objective toxic side effects occur, the dose should be reduced or the agent should be changed under expert guidance, and the side effects should be recorded in detail.  (3) Women of childbearing age should avoid or terminate pregnancy during use as prophylactic medication.  (1) Registration system for occupational exposure: Physicians who visit the clinic should fill out the “Case Registration Form for HIV Occupationally Exposed Persons” to register, keep and report the occupational exposure.  (2) Monitoring of occupationally exposed persons: HIV antibody should be monitored regularly within 1 year after exposure, i.e. 4 weeks, 8 weeks, 12 weeks and 6 months after exposure.  (3) Instruct patients to practice safe sex for 1 year.