Merchant Roland C, Katzen Jeremy B, Mayer Kenneth H, Becker Bruce M
Department of Emergency Medicine, Brown Medical School, Providence, Rhode Island, USA.
Prehosp Disaster Med. 2007 Jul-Aug;22(4):330-4. doi: 10.1017/s1049023x00004969.
The demography of healthcare workers (HCWs) and non-HCWs seeking medical care at emergency departments after a non-percutaneous potential exposure to human immunodeficiency virus (HIV) during cardiopulmonary resuscitation (CPR), the types and body locations of their exposures, the time elapsed from exposure to emergency department presentation, and usage of HIV-post-exposure prophylaxis (PEP) for these exposures are described.
A retrospective study of emergency department patients who were exposed to blood or body fluids during CPR in Rhode Island from January 1995-June 2001 was performed. The demography, characteristics of the exposure, and HIV-PEP usage for these patients were compared, and the elapsed time from exposure to evaluation in the emergency department was calculated.
Of the 39 patients exposed to non-percutaneous blood or body fluid during CPR, 22 were healthcare workers (HCWs) and 17 were non-HCWs. Thirty-four patients sustained mucous membrane exposures. Most of the patients (69.2%) were exposed to saliva or sputum (p <0.001), experienced a mouth exposure (71.8%; p <0.0001) and presented to the emergency department within one day of their exposure (84.4%; p <0.0001). Three HCWs and no non-HCWs were offered HIV-PEP for their CPR exposure. Of the three HCWs offered PEP, two actually received it.
Nearly half of the patients who presented with non-percutaneous exposures acquired during CPR were not HCWs. Most of the exposures were to saliva or sputum and occurred on their mucous membranes. Continuing education programs on maintaining universal precautions to prevent blood or body fluid exposures and appreciating the benign nature of most non-percutaneous exposures possible during CPR are needed.
描述了在心肺复苏（CPR）期间非经皮潜在暴露于人类免疫缺陷病毒（HIV）后到急诊科寻求医疗护理的医护人员（HCW）和非医护人员的人口统计学特征、暴露的类型和身体部位、从暴露到就诊于急诊科所经过的时间，以及针对这些暴露使用HIV暴露后预防（PEP）的情况。
对1995年1月至2001年6月在罗德岛州心肺复苏期间暴露于血液或体液的急诊科患者进行回顾性研究。比较了这些患者的人口统计学特征、暴露特点和HIV-PEP的使用情况，并计算了从暴露到在急诊科接受评估所经过的时间。
在39例心肺复苏期间非经皮暴露于血液或体液的患者中，22例为医护人员，17例为非医护人员。34例患者发生了黏膜暴露。大多数患者（69.2%）暴露于唾液或痰液（p<0.001），口腔暴露（71.8%；p<0.0001），并且在暴露后一天内就诊于急诊科（84.4%；p<0.0001）。3名医护人员因心肺复苏暴露接受了HIV-PEP，没有非医护人员接受。在接受PEP的3名医护人员中，2名实际接受了PEP。
近一半在心肺复苏期间出现非经皮暴露的患者不是医护人员。大多数暴露是唾液或痰液，且发生在黏膜上。需要开展持续教育项目，以维持预防血液或体液暴露的普遍预防措施，并认识到心肺复苏期间大多数非经皮暴露的良性性质。
