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Performance Matters - Exposure to Blood Borne Viruses (BBV)

The LMC is regularly involved in representing and supporting doctors who have been identified as having “performance” issues. The LMC has identified a number of themes which recur, and this regular feature will highlight these, so that our members can avoid these pitfalls.

Exposure to Blood Borne Viruses (BBV)

What do you do if one of your staff or patients is exposed to a blood borne virus? This is not a question which we often have to answer. Recently though two incidents have highlighted the need for practices to seek an answer to this question.

The Lincolnshire-wide BBV policy sets out precisely what we should do for both patients and staff. This policy is available in the link above.

If exposure occurs, there is a useful flowchart in the policy which guides what actions should then take place.The LMC recommends that practices have a copy of the BBV flowchart available as an aide memoire for clinicians.

If a needle stick injury or other exposure occurs, the first action is to wash the wound, or mucous membrane. The wound or broken skin should be washed liberally with soap and water, but without scrubbing. A puncture wound should be encouraged gently, but the wound should not be sucked. For mucous membranes, they should be irrigated copiously with water. Contact lenses should be removed before this for eye exposures.

The type of exposure should also be assessed. If the risk is low, then no further action is needed. If the risk is significant, then the patient should be referred for further specialist assessment. It is not the responsibility of GP practices to assess the need for post-exposure prophylaxis (PEP), and we should not be prescribing this.

For non-NHS related exposure, for instance, a carer in a residential home who gets a needle stick injury, the policy gives advice to wash the affected area and to direct the patient to the local emergency department.

For NHS related exposure the member of staff should be advised to wash the affected area, and to attend occupational health in hours, or the ED in the out of hours period. Occupational health can be contacted in hours by calling 01522 573597