Blood exposure accident
Every day in our practices, we handle all kinds of dangerous instruments that increase the risk of cuts. This threat hanging over us, healthcare professionals and Podiatrists, can manifest at any time.
During any sharps accident, the Podiatrist is exposed to the risk of contact with a patient's blood. According to the Bordeaux center of coordination of the committees for the fight against nosocomial infections (CCLN), a blood exposure accident (AES) is defined as any contact with blood or contaminated biological fluid occurring through skin penetration, splashing onto a mucous membrane or injured skin.
This subject is at the heart of our profession, which is why My Podologie wants to talk to you about it.
The AES protocol
The protocol in the event of a blood exposure accident is a rigorous procedure allowing to limit and manage as early as possible all risks related to contact with another individual's biological fluid. It is divided into 6 key steps, each having an important role.
1. Immediately stop the treatment
The moment of awareness of the accident occurs when the healthcare practitioner recognizes having suffered a needle stick, cut, contact with injured skin or even a splash on their ocular mucous membranes with blood or contaminated biological fluid from their patient. Treating the emergency is an absolute necessity. This is why the Podiatrist must absolutely stop their treatment to focus on carrying out the steps of the AES protocol.
2. Perform first aid
You perform the first emergency steps:
For cases of needle stick, cut and contact with damaged skin...
The primary goal is not to make the wound bleed. You then apply pressure to the injured area using a sterile compress. Clean the wound or contact area using water and mild liquid soap. Rinse generously with water then pat dry using a sterile compress.
Perform antisepsis of the injured area by applying an antiseptic solution (stabilized Dakin, Dermal Betadine, 70° modified alcohol) for 5 minutes. You can immerse the affected area in an antiseptic solution or apply a saturated swab.
For the case of splash on the ocular mucous membranes...
Rinse your eyes generously using water or physiological serum for at least 5 minutes.
3. Contact the appropriate people
Attention, the current health situation is not a reason to exclude the practitioner's visit to the hospital in the event of an AES. You can go there because it is an emergency. The people to contact at this step of the protocol are either the emergency room or the AES medical referent.
Within the 4 hours following the accident, you must:
- Have a blood test to examine the serology of certain types of viruses (HIV, HBV, HCV).
- Assess the infection risk, by observing the type of injury, the patient's serological status.
- Possibly start a prophylactic treatment* in agreement with the referring doctor.
*Set of medical means implemented to prevent the appearance, aggravation or extension of diseases.
4. Report the workplace accident
Two different cases are to be presented:
For employees...
The workplace accident must be reported to their employer within a maximum of 24H
For self-employed professionals and employers...
The workplace accident must be reported within a maximum of 48H. The employer will have to send medical proof (certificate) to the CPAM to fulfill the conditions. The self-employed healthcare professional will have to do the same by contacting their insurance.
5. Follow-up of the injured person over time
After having done all the previous steps, the state of the healthcare professional will have to be checked by a doctor, who will have to very carefully check the injured person's complementary exams (serologies) and any atypical clinical signs.
6. Analyze and take a step back from your accident
It is important to take a step back from what may have happened to be able to point out what caused the occurrence of this accident. This time of personal reflection will allow the practitioner to change their behavior in the office in the event that it caused this mishap.
Some precautions
In order to carry out the correct implementation of the AES protocol as quickly as possible, the ONPP (National Order of Podiatrists-Podologists) has made it mandatory to display the contact details of the AES referring doctor and the nearest hospital center (Emergency) in Podiatry-Podology offices.
It is important to remember that all OPCT (Sharp, cutting, sharp object) equipment is likely at the origin of contaminations whether in podiatry treatment or in its decontamination process.
As we all know, you should never extract your scalpel, gouge or other blades by hand even if we wear our treatment gloves. We can separate the different blades from the different handles either using pliers or blade extractors designed for this purpose?
To conclude
My Podologie simply hopes that you never need to resort to the protocol explained above! Take care of yourself!
