Handling positive cases of hiv and hepatis b

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A POWER POINT PRESENTATION BY DR. SANGEETA CHOWDHRY & DR. SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)

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Handling positive cases of hiv and hepatis b

  1. 1. HANDLINGHIVINFECTEDANDHEPATITIS-BPOSITIVE CASE
  2. 2. A POWER POINT PRESENTATIONBYDR.SANGEETA CHOWDHRY&DR.SUNIL SHARMADEPARTMENT OF FORENSIC MEDICINE&TOXICOLOGYGOVT. MEDICAL COLLEGEJAMMU (JAMMU AND KASHMIR)
  3. 3. THOUGH IN DISTANT TIME, YOU MAY NOT LOVE ME SO;I SHALL ALWAYS KEEP YOU CLOSE AND NEVER LET YOU GO.
  4. 4. SUSPICION OF HIVHIV should be suspected if thebody is ofA male homosexualAn intravenous drug abuserA haemophiliac who has receivedrepeated blood transfusionsA female prostituteA victim of sex abuse
  5. 5. A MALE HOMOSEXUALMALE HOMOSEXUAL
  6. 6. AN INTRAVENOUS DRUG ABUSER
  7. 7. A HAEMOPHILIAC WHO HAS RECEIVED REPEATEDBLOOD TRANSFUSIONS
  8. 8. A FEMALE PROSTITUTE
  9. 9. A VICTIM OF SEX ABUSE
  10. 10. PRECAUTIONS FOR STAFFAll staff working in close associationof HIV patients should be:-Vaccinated against Hepatitis-BRe-vaccinated at intervals when thebody titres falls below protective levelAvoid direct contact with of skin andmucous membranes with body fluidsand tissuesHands should be washed after eachactivity with soap and water even ifgloves are worn
  11. 11. SPECIAL PRECAUTIONS ARE MANDATORYAt the scene of crimeIn the autopsy roomIn the laboratoryIn the courtGeneral precautions
  12. 12. AT THE SCENE OF CRIME
  13. 13. Disposable shoe protection by person at thescene of crimeFoods or smoking should not be allowed atthe scene of crimeBlood-contaminated clothing or any othermaterial should be handled carefully. Dried-blood or wet blood material that is not to usedas evidence should be decontaminated andproperly disposed off by incineration.Non-disposable material used during theinvestigation and collection of the evidenceshould be decontaminated by usualhypochlorite solutionAT THE SCENE OF CRIME
  14. 14. IN THE AUTOPSY ROOM
  15. 15. IN THE AUTOPSY ROOMAdmission:-no unauthorised person should beallowed in the autopsy and body preparation roomClothing:-all protective gears, (to completelycover the body) like wearing doublegloves, gowns, water-proofapron, caps, masks, goggles if eye glasses are notworn, and shoe coverInstruments:- minimum instruments should bekept. To start with; scalpel, scissors, knife andartery forceps should be used. The instrumentsshould be slightly blunt unless required to avoidany injury to the working handcont....................
  16. 16. Disposal requirement:-all material/protective gearsused during the autopsy must be disinfected, sterilisedor incinerated as applicableHandling specimens for laboratory purposes:-at alltimes during autopsy; gloves should be worn by all thepersons working with these suspected cases.Clean –up procedure:- all splatters and spills of bloodand other body fluid should be wiped with disposabletissues or towels which can be discarded in bio-hazardbags and properly disposed off and the area be cleanedwith disinfectant.cont.................IN THE AUTOPSY ROOM
  17. 17. IN THE AUTOPSY ROOMDisinfection:- a solution of 1:10 dilution of household bleachor freshly prepared solution of sodium hypochlorite(equivalent to5000ppm) should be usedAccidental injury or prophylaxis:- in case of any mishapresulting in injury; matter should be reported to theconcerned authorities after proper disinfection of the wound.Blood sample should be taken from the site of exposure ofwound and from the injured person for immediate testing ofHIV and Hepatitis-B and keep these records for followup/comparison at an interval of 6weeks, 3 months,6 monthsand 1 year. All suspected exposed cases of HIV should begiven ZIDOVUDINE, 500mgms x twice a day x 6 weeks.Persons exposed to Hepatitis-B and who have not beenprophylactically vaccinated for it; must be given Hepatitis-Bimmunoglobulin within 72 hours of the incident , followed byactive vaccination.
  18. 18. IN THE LABORATORY
  19. 19. Disposable gloves should be worn and countertop cover used in areas where biologicalmaterial is examined. They should be disposedoff properly.Food or smoking should not be allowed in theworking areaAll biological specimens should be consideredas contaminated and disposed off properlyMouth-pipetting of biological material shouldnot be practisedAll specimens should be destroyed by burningor chemically decontaminatedHands should be washed before leaving thework areaIN THE LABORATORY
  20. 20. IN THE COURT
  21. 21. Whenever possible, all biologicallycontaminated material should be referred byphotographic or other means rather thanpresenting in the courtWhenever necessary bullets, clothing, etcshould be handled using disposable glovesand paper, or the (dry-not wet/moist)evidence should be enclosed in asealed, clear, plastic bagHands should be washed after handlingthe evidenceIN THE COURT
  22. 22. GENERAL PRECAUTIONS
  23. 23. Prevention is better than curement. The best way to controldissemination of HIV and Hepatitis-B is prevention which includes:- Avoiding unnecessary contamination of the work area, keepingthings need and clean, restricting the flow of water and other fluidswithin the limited bounds of the work area Minimising and taking care of injuries Create an atmosphere of free aerosol of biological materialsuch as that produces saw during autopsy. Use of dustless saw isthe need of the hour. All efforts should be made to tackle all type of contaminationwhich includes washing of hands, cleaning floor, doors, doorknobs, telephone apparatus/mobiles etc. with a disinfectant ofkilling viruses and thereby protecting the health workers.GENERAL PRECAUTIONS
  24. 24. THANK YOUABC OF AIDSA-AVOID UNSAFE SEXB-BE FAITHFUL TO YOUR SPOUSE(and if not possible; use)C-CONDOMS

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