|
Date of Report: 02//2004
Source: National HIV/AIDS Clinicians' Consultation Center
Scenario: It is 6 pm and a concerned nurse approaches you because she thought the tip of a bloody 22-gauge needle might have
stuck her. When she took off her glove, there was no sign of puncture. The source patient is known to be HIV-positive with a CD4+
count of 20 cells/mL and a viral load of 5000 copies/mL. The patient is taking zidovudine, lamivudine, and efavirenz. You follow
post-exposure prophylaxis protocol but are uncertain whether this represents a true exposure requiring prophylaxis and if so,
whether two or three drugs would be appropriate. Clinical scenarios such as these present multiple decision-making dilemmas. Real-
time discussion of complicated cases with other HIV experts can be useful in choosing the best and most individualized patient care
strategies. The National HIV/AIDS Clinicians' Consultation Center has two free national services that can help clinicians manage
these types of scenarios, the National HIV Telephone Consultation Service (Warmline) and the National Clinicians' Post- Exposure
Prophylaxis Hotline (PEPline).
The Warmline provides consultation about the entire range of issues in HIV care, from diagnostic measures to complicated
antiretroviral therapy.
The PEPline provides emergency consultation when needlesticks and other exposures to blood borne pathogens occur. Immediate
assessment and management are essential because post-exposure prophylaxis can be extremely helpful when initiated promptly.
Physicians and clinical pharmacists experienced in HIV care and post-exposure prophylaxis (PEP) for healthcare workers staff the
Warmline and PEPline. They have responded to more than 70,000 calls during the past 10 years. There is no fee for either of these
services.
Call the Warmline between 5 am and 5 pm Pacific Time at (800) 933-3413
The PEPline can be reached 24 hours/day, 7 days/week at (888) 448-4911
|
