Needle Stick/Blood and Body Fluid Exposures
Downtown and Community Campuses (General Student Instructions)
In the event of exposure to blood or body fluids you should IMMEDIATELY:
- Wash the affected area with soap and water.
- Notify Employee Health during weekday hours (7:30 am - 4:00 pm) at 464-4260.
- Report to the Emergency Department after hours or on weekends, and identify yourself as an Upstate employee, student or affiliate. Follow up with Employee Health on the next business day.
- Complete Injury Report
If an exposure occurs while you are visiting another facility, please follow that facility's exposure protocol. Also, please contact the Student Health Office at (315)464-5470, ext 4, as soon as possible to make us aware of the exposure.
Student Exposure to Infectious and Environmental Hazards
(Specific Student Guidelines)
- Methods of Prevention: The policies below outline procedures aimed at preventing exposure to infectious and environmental hazards in a healthcare setting.
- Proper Response to Blood and Body Fluid Exposure
Exposures in University Hospital and Other Syracuse Area Facilities
- Immediately wash the affected area with soap and water or for eye involvement, flush with clean water or normal saline
- Call Employee/Student Health (ESH) at 464-4260 on weekdays between 7:30 AM - 5 PM
- Report to the University Hospital Emergency Department after hours, weekends and holidays
- An Injury Report must be completed and submitted to Employee/Student Health
Exposures in Facilities Outside of the Syracuse Area
- Immediately wash the affected area with soap and water or for eye involvement, flush with clean water or normal saline.
- Immediately report to the nearest Emergency Department unless the student is familiar with the specific facility procedure for exposures.
- If exposure occurs in an outpatient setting, report to the nearest Emergency Department without delay.
- Call ESH to report the exposure. If after hours, leave a voicemail message and a contact number.
- Follow-up testing is coordinated by ESH
Post-exposure Evaluation and Management
- Notify ESH as soon as possible, regardless of the facility where the exposure occurred
- ESH or the Emergency Department practitioner determines the type and extent of exposure and coordinates assessment and testing of the source patient for HIV, hepatitis B and hepatitis C
- Baseline testing is obtained on the exposed individual for hepatitis B, hepatitis C, and HIV, if indicated
- Testing of source patient is done with appropriate consent
- Counseling is provided by the ESH or Emergency Department practitioner - information about the risk of the exposure, risk/benefit of post-exposure prophylaxis (PEP) and follow-up plan
- No risk of blood borne infection - PEP is not indicated
- Source patient is HIV positive or unknown - begin PEP (ideally within 1 hour of exposure, but no later than 36 hours)
- Source patient is HIV negative - PEP is not indicated
- Follow-up testing is arranged by ESH
- Effects on Medical Student Learning Activities
In the event of exposure, medical students should contact Student Health as soon as possible. If learning activities are interrupted, the Director of Student Health, upon verification and understanding of specific scenario, will contact the Dean of Student Affairs. The Dean will communicate and make arrangements with faculty regarding absence, make up of work, and future action plan.
Cost Management for Urgent Student Blood and Body Fluid Exposure Follow-up
By decision of Upstate leadership and Department of Emergency Medicine, initial evaluation and management of matriculated students for blood or body fluid follow-up at Student Health or Upstate University Hospital Emergency Department will have remaining expenses after insurance payment written off. For cases evaluated and managed at non University Hospital sites, students will be reimbursed for out-of-pocket costs, after insurance, for testing/treatment that occurs outside of University Hospital after the first 90 days of the event.
Students with potential contact to human immunodeficiency virus (HIV), hepatitis B and/or hepatitis C through blood or body fluid exposure during clinical activities should seek immediate evaluation and consideration of post-exposure prophylaxis (PEP). Anti-viral medication ideally should be administered within two hours when indicated.
Student Health B & BF Follow-up (Mon. - Fri., 7:30 AM - 4 PM)
- Medical assessment, laboratory evaluation, PEP if indicated
- No charges are submitted for billing
- No bill is generated
Emergency Department B & BF Follow-up (all other times)
- Medical assessment, laboratory evaluation, PEP if indicated
- A bill is submitted to the student’s health insurance (for above services + professional fee)
- Billing for charges not covered by insurance will be generated and sent to the student
- Student brings the bill(s) to Student Health for verification.
- Student Health forwards the hospital bill to Financial Services (Kristine Burke or Lisa Kustyn) and bill for professional services to the Dept. of Emergency Medicine (Janice Harvey) for write off of remaining charges.
External Clinical Sites B & BF Follow-up
After-insurance expenses for medical services provided outside of the Upstate Medical Health System for B & BF exposure may be submitted for reimbursement. The exposure must have occurred during an Upstate sanctioned educational or volunteer activity. After the student’s insurance has paid its portion of the bill, the university will reimburse the student for the after-insurance balance for the initial assessment, prophylactic treatment and necessary tests within three months of the exposure. The amount reimbursed may include co-insurance and co-pay charges, but not annual deductibles exceeding $200*.
*Some students, or if covered under their parent’s insurance, may have very high deductible policies to lower health insurance costs. A deductible is the amount paid for health care services before your health insurance begins to pay. The deductible is part of the cost of the policy and is separate from the coverage for an event requiring medical care.
The university cannot process a payment to a health care facility on a student’s behalf. Therefore, all claims will be processed as reimbursements. In order to receive reimbursement, the student’s health insurance must be billed first. The student must pay the remaining balance and submit the following documents to Student Health for review and approval for reimbursement:
- Student Blood and Body Fluid Exposure Expenses Reimbursement Form .
- An itemized bill.
- Explanation of Benefits (EOB) from insurance company.
- Paid Receipt.