Scribd Logo
Upload

Welcome to Scribd!

  • 115 views

    NPEP Procedure Flowchart Template

    Uploaded by

    dedekfriday
    The document provides guidelines for managing potential exposure to HIV in emergency departments, including assessing eligibility for non-occupational post-exposure prophylaxis (NPEP) based on risk and within 72 hours of exposure. It references national guidelines for initiating NPEP and includes algorithms for triaging patients and prescribing starter packs along with follow-up care and referrals. Risk assessment involves determining if the exposure was high risk, the source was known to be or likely HIV positive, and treatment was sought within 72 hours.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    NPEP Procedure Flowchart Template

    Uploaded by

    dedekfriday
    115 views2 pages
    The document provides guidelines for managing potential exposure to HIV in emergency departments, including assessing eligibility for non-occupational post-exposure prophylaxis (NPEP) based on risk and within 72 hours of exposure. It references national guidelines for initiating NPEP and includes algorithms for triaging patients and prescribing starter packs along with follow-up care and referrals. Risk assessment involves determining if the exposure was high risk, the source was known to be or likely HIV positive, and treatment was sought within 72 hours.

    Original Description:

    template NPEP flowchart

    Copyright

    © © All Rights Reserved

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document provides guidelines for managing potential exposure to HIV in emergency departments, including assessing eligibility for non-occupational post-exposure prophylaxis (NPEP) based on risk and within 72 hours of exposure. It references national guidelines for initiating NPEP and includes algorithms for triaging patients and prescribing starter packs along with follow-up care and referrals. Risk assessment involves determining if the exposure was high risk, the source was known to be or likely HIV positive, and treatment was sought within 72 hours.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    115 views2 pages

    NPEP Procedure Flowchart Template

    Uploaded by

    dedekfriday
    The document provides guidelines for managing potential exposure to HIV in emergency departments, including assessing eligibility for non-occupational post-exposure prophylaxis (NPEP) based on risk and within 72 hours of exposure. It references national guidelines for initiating NPEP and includes algorithms for triaging patients and prescribing starter packs along with follow-up care and referrals. Risk assessment involves determining if the exposure was high risk, the source was known to be or likely HIV positive, and treatment was sought within 72 hours.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    Management of non-occupational exposure to HIV in emergency departments

    This procedure is intended to facilitate the management of incidents involving potential exposure to HIV
    infection in the non-occupational context, ensuring compliance with the:
    Post-Exposure Prophylaxis after Non-Occupational and Occupational exposure to HIV: Australian
    National Guidelines (Second edition), (2016)

    The decision to initiate (or not) non-occupational post-exposure prophylaxis (NPEP) and the
    baseline procedures required are guided by the flow charts in this document. The
    Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) and the
    Committee for these Guidelines strongly recommend that reference also be made to the
    National Guidelines before any decision to initiate NPEP in ED

    www.pep.guidelines.org.au

    Algorithm for management of NPEP for HIV in an emergency department

    Potential exposure to HIV

    Emergency response – TRIAGE 3

    Establish eligibility for HIV NPEP using the risk assessment flowchart
    and
    pp. 6-8 of the Guidelines

    Prior to prescribing NPEP, consult with the ED Staff Specialist and consider consultation with the
    on-call Infectious Diseases Consultant or Sexual Health Physician particularly if the patient is:
     pregnant or breast feeding
     has significant medical co-morbidities, in particular compromised renal function

    Call <number> and ask for the on-call specialist to be paged.

    No NPEP
    Yes
    prescribed?

    Provide prevention  Provide a 7-day NPEP starter pack (located in <the


    information after-hours medication cupboard - both two-drug and
    HIV, STI and BBV three-drug regimens are available>) along with
    education about potential side-effects and medication
    adherence
     Conduct baseline testing p.13 of the Guidelines.
     Copy the baseline testing results to the GP or centre

    Refer to local GP or Sexual Health Provide prevention information


    Clinic for STI and BBV screening on HIV, STI and BBV
    NPEP prescribed?

     Refer for ongoing management (within 7 days) to local


    No sexual health services
     Document follow up arrangements
    Refer:  Provide patient with referral letter and information sheet

     To local sexual health clinic See


    list of Local Sexual Health
    clinics in PEP folder
     For crisis intervention
    Risk assessment flowchart

    CONSIDER NPEP IF CONDITIONS 1, 2 AND 3 ARE MET

    1
    HIGH RISK EXPOSURE

    Condomless receptive intercourse (anal or vaginal)i

    Condomless insertive intercourse (anal or vaginal) i

    Use of contaminated injecting equipment
    i
    Condomless means no condom used or condom slippage/breakage.

    Notes: Condomless receptive oral intercourse with ejaculation MAY BE CONSIDERED as a high risk exposure
    providing the source is known to be HIV-positive with a detectable HIV viral load and there is oral mucosal
    disease or an open lesion in the mouth or throat.

    Significant exposure of non-intact skin with blood, sperm or vaginal fluids MAY ALSO BE CONSIDERED as a
    high risk exposure providing the source is known to be HIV positive with a detectable HIV viral load.

    Source is known to be HIV infectedii


    OR
    Source is likely to be at increased risk of HIV

    Men who have sex with men

    Heterosexual person who injects drugs

    A person from a high HIV prevalence country (HIV prevalence > 1.0%)iii

    A sex worker OUTSIDE of Australia
    ii
    NPEP is NOT RECOMMENDED following insertive/receptive anal, vaginal or oral sex, sharing of needles or
    other injecting equipment, and mucous membrane and non-intact skin exposure when the source viral load is
    KNOWN to be undetectable – this is provided the source is known to be compliant with medication, attends
    regular follow-up and has no intercurrent STI.
    iii
    Data available at: http://aidsinfo.unaids.org/

    3
    The patient presents within 72 hours of exposure

    1 + 2 + 3 = NPEP

    You might also like