You are a fourth-year medical student and super-excited to be doing your first supervised central line procedure on an actual patient. You have done so many central lines on mannequins and simulations. You feel ready. In your excitement, however, you stick yourself with the 22 gauge finder needle after you successfully get a flash-back of the patient's venous blood.
After handing off the procedure to your senior resident, you go into a mild panic. Your patient is a known HIV patient with an unknown CD4 count and viral load. After taking off your gloves and washing your hands, you report this to the attending.
Should you start post-exposure prophylaxis medications for HIV? You remember that if post-exposure HIV medications are recommended, you should start it immediately and definitely within 2 hours of exposure.
It's difficult to concentrate when faced with so many questions whirling in your mind.
Trick of the Trade:
Use the National Clinicians' Post Exposure Prophylaxis (PEP) Hotline - 1-888-448-4911
"The PEPline provides around-the-clock expert guidance in managing healthcare worker exposures to HIV and hepatitis B and C. Callers receive immediate post-exposure prophylaxis recommendations. Available 24/7."
Remember this is for providers who are exposed and not the lay public.
I was not only surprised to find that this national hotline is hosted by UCSF/SFGH (my home institution!) but also helmed by my friend Dr. Goldschmidt (Professor and Vice Chair, Department of Family and Community Medicine).
For more information about the National HIV/AIDS Clinicians' Consultation Corner, which staffs the PEPline, view their website at: http://www.nccc.ucsf.edu/about_nccc/pepline/
On the website, they also feature a "Warmline" at 800-933-3413, which is staffed by physicians, clinical pharmacists and nurse practitioners Mondays through Fridays, from 5 am to 5 pm (Pacific Time). They provide up-to-date information for the care of your HIV-positive patient.