Blood exposure accident
Every day in our offices, we handle all kinds of dangerous instruments that increase the risk of cuts. This threat that hangs over us, health professionals and Podiatrists, can manifest itself at any time.
In the event of any sharp accident, the Chiropodist-Podiatrist is exposed to the risk of contact with a patient's blood. According to the Bordeaux Center for Coordination of Nosocomial Infection Control Committees (CCLN), a blood exposure accident (AES) is any contact with blood or a contaminated biological fluid occurring through skin breakage, projection onto a mucous membrane or onto damaged skin.
This subject is at the heart of our profession, which is why My Podologie would like to talk to you about it.
The AES protocol
The blood exposure accident protocol is a rigorous procedure to limit and manage as early as possible all risks related to contact with another individual's biological fluid. It is subdivided into 6 key steps, each of which has an important role.
1. Stop the treatment immediately
The moment of awareness of the accident occurs when the health practitioner recognizes having suffered a prick, cut, contact with damaged skin or even a projection on his ocular mucous membranes with blood or a contaminated biological fluid from his patient. Treating the emergency is an absolute necessity. This is why the Chiropodist-Podiatrist must absolutely interrupt his treatment to concentrate on carrying out the steps of the AES protocol.
2. Perform first aid procedures
You perform the first emergency actions:
For cases of stings, cuts and contact with damaged skin...
The primary goal is to prevent the wound from bleeding. 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 thoroughly with water and then pat dry using a sterile compress.
Practice antisepsis of the injured area by applying antiseptic solution (Dakin stabilized, Betadine dermal, Modified alcohol 70°) for 5 minutes. You can immerse the affected area in antiseptic solution or apply a swab soaked to saturation.
In the case of projection on the ocular mucous membranes...
Rinse your eyes generously with water or saline solution for at least 5 minutes.
3. Contact the appropriate people
Please note that the health situation we are experiencing today is not a reason to exclude a visit to the hospital by the practitioner in the event of an AES. You can go there because it is an emergency. The people to contact at this stage of the protocol are either the emergency department or the AES medical referent.
Within 4 hours of the accident you must:
- Take a blood test to examine the serology of certain types of virus (HIV, HBV, HCV).
- Assess the risk of infection, by observing the type of injury and the patient's serological situation.
- If necessary, start prophylactic treatment* in agreement with the referring physician.
*Set of medical means implemented to prevent the appearance, worsening or spread of diseases.
4. Notify the work accident
Two different cases are to be presented:
For employees...
The work accident must be reported to your employer within a maximum of 24 hours.
For professionals and employers...
The work accident must be reported within a maximum of 48 hours. The employer must send medical proof (certificate) to the CPAM to meet the conditions. The independent health professional must do the same by contacting their insurance.
5. Monitoring the injured person over time
After having completed all the previous steps, the health professional's condition will have to be checked by a doctor, who will have to very carefully check the additional examinations of the injured person (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 in order to be able to pinpoint what led to this accident occurring. This time for 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 ensure that the AES protocol is properly implemented as quickly as possible, the ONPP (National Order of Chiropodists and Podiatrists) has made it mandatory to display the contact details of the AES referring physician and the nearest hospital (Emergency Department) in Chiropodist and Podiatrist practices.
It is important to remember that all OPCT (sharp, cutting, pointed object) material is likely to be the source of contamination, whether in pedicure care or in its decontamination process.
As we all know, you should never remove your scalpel, gouge or other blades by hand even if you are wearing your care 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!
