The URL can be used to link to this page

Home My WebLink About203.010g - Post-Exposure Protocols Effective Date: February 2019 Kevin Reynolds, Fire Captain Current Revision Date: 07/10/2025 Section 203.010g Next Revision (2) Date: 07/10/2028 Page 1 of 4 200 Standard Operating Procedures Manual SECTION 203.010g POST-EXPOSURE PROTOCOLS PURPOSE The purpose of this policy is to provide Fresno Fire Department (FFD or Department) members with a defined procedure to handle a potential exposure to bloodborne or airborne pathogens. APPLICATION This section intentionally left blank. OPERATIONAL POLICY • Any member exposed to potentially infectious material shall immediately wash the exposed area with soap and water or saline eye wash if the eyes are involved. • Any member having an occupational communicable disease exposure shall immediately report the exposure to his/her supervisor. • Supervisors shall ensure a Department Infection Control Officer is contacted at (559) 621-4155. Leave a message if there is no immediate answer and complete a supervisor’s report of injury and/or appropriate workers’ compensation paperwork if necessary. • Any member exposed to any of the following conditions shall immediately contact the Infection Control Officer and complete the applicable report(s) listed below: Required Reports (as applicable): o EMS-15 Communicable Disease Exposure Report o EMS-16 Request for Notification: Communicable o EMS-17 DICO Exposure Interview Report Fresno City Fire Department Effective Date: February 2019 Kevin Reynolds, Fire Captain Current Revision Date: 07/10/2025 Section 203.010g Next Revision (2) Date: 07/10/2028 Page 2 of 4 Exposure Types Include: o A break in skin caused by a potentially contaminated object. o Splash of blood or other potentially infectious material onto eyes, mucous membranes, or non-intact skin. o Mouth-to-mouth resuscitation. o Other exposure(s) the member may feel significant. o Airborne exposure to communicable disease. • The report shall include details of the task being performed, the means of transmission, the portal of entry, and the type of personal protective equipment (PPE) in use at the time. • After an exposure, there is a two-hour window where the HIV prophylaxis is the most effective, and there are three ways to initiate source patient testing: • The first responder can report to the emergency department where the source patient was taken for care (CRMC ER, Clovis ER, Kaiser, or Saint Agnes Medical Center ER). o The ER will provide care to the first responder, order baseline labs, and initiate the BSE protocol. o The ER will consent the source patient and have blood drawn and tested for HCV, HBV, and rapid HIV. o The rapid HIV status will be reported to the first responder as soon as available. o The HCV and HBV take longer and will be reported to the first responder by Employee Health Services (EHS) when the final report is available. • The first responder can report to Kaiser to initiate the BSE protocol (this may take longer). o Kaiser will initiate the BSE protocol and provide care. o Kaiser will need to contact the hospital supervisor at either CRMC or Clovis to get the source patient consented, blood drawn and tested. Effective Date: February 2019 Kevin Reynolds, Fire Captain Current Revision Date: 07/10/2025 Section 203.010g Next Revision (2) Date: 07/10/2028 Page 3 of 4 o Kaiser will be contacted by the hospital supervisor with the rapid HIV results as soon as available. o Kaiser can instruct the first responder to report to EHS on the next business day to get information regarding the source patient HCV and HBV status. • The supervisor shall review the Communicable Disease Exposure Report and forward it to the Infection Control Officer no later than the end of the day or shift in which the exposure occurred. • Upon receipt of the Communicable Disease Exposure Report, the Infection Control Officer shall contact the exposed member to ensure post-exposure procedures have been followed. If no exposure occurred, the Infection Control Officer shall counsel the member on exposure hazards. • The Infection Control Officer shall perform or refer members for infection control retraining or for stress management counseling, if indicated. • Upon request, the source patient can be traced to the receiving medical facility by the Infection Control Officer. The Infection Control Officer shall notify the receiving facility a communicable disease exposure occurred, and request an infectious disease determination, as provided under the Ryan White CARE Act of 1990. • Request for consent to test the source patient for HIV and HBV can be made. The source patient has the right to refuse such testing under the California Code, Health and Safety Code, Section 199.65). • The approved job care facility shall provide appropriate diagnostic workup and treatment of members with communicable disease exposures. Services shall include long-term follow-up and member/spousal counseling. • Under the Ryan White CARE Act of 1990, Fresno County Health Services and/or medical treatment facilities shall notify the Department Infection Control Officer of any patient transported by members of the Department with a diagnosis of an airborne transmissible disease. When notified, the Infection Control Officer shall contact members involved and schedule medical evaluation with a City physician or appropriate Department of Health testing clinic. Effective Date: February 2019 Kevin Reynolds, Fire Captain Current Revision Date: 07/10/2025 Section 203.010g Next Revision (2) Date: 07/10/2028 Page 4 of 4 • Under Senate Bill 1518, Fresno County Health Services and/or medical treatment facilities shall provide similar notification of diagnosis of bloodborne or other potentially communicable disease if a member provided care or transportation to the source patient and if disease transmission could have occurred. This policy shall be enforced through cooperative agreements between medical treatment facilities and this Department. Patient confidentiality shall be preserved in any notification procedure. OPERATIONAL GUIDELINE This section intentionally left blank. PROCESS This section intentionally left blank. INFORMATION This section intentionally left blank. DEFINITIONS This section intentionally left blank. CROSS-REFERENCES Standard Operating Procedures Manual Section 203.010, Infection Control Section 203.010a, Health Maintenance Section 203.010b, Infection Control Training Section 203.010c, Personal Protective Equipment Section 203.010d, Scene Operations Section 203.010f, Post-Response Section 203.010h, Station Environment Section 203.010i, Compliance and Quality Monitoring/Program Evaluation Ryan White CARE Act of 1990 California Senate Bill 1518