Needlestick aksidaa, gaañannde siriŋ werlaa, e ɓuuɓri caggal ɓuuɓri¶
Torlaade gaañannde punndi accidentel ummoraade e ƴiiƴam hipodermik kuutorteeɗam, lancet, walla kuutorgal safaara ɓuuɓngal, ko huunde nde alaa ɗo haaɗi, nde addanta neɗɗo kulol mawngol e ñawu nguu. Ɗee gaañanɗe ina mbaɗa e nokkuuji ɗiɗi ceertuɗi : eɓɓooji cellal walla njuɓɓudi laaɓal (infirmiyee en, safrooɓe, flebotomist en, gollotooɓe e dental, gollotooɓe e galleeji, e gollotooɓe e mborosaaji ɓuuɓɗi ina njuutee e sahaa nde ina njuutee e mborosaaji ɓuuɓɗi walla saakuuji mborosaaji) e **renndo ɓuuɓngo-syringe up.syrenchild sticks or e nder park jamaa, e nder maayo, e nder nokku pijirlooji, walla e nder suudu safrirdu transit, walla mawɓe piɗtaali ina njottoyoo e nder laylaytol renndo walla e nder jooɗorde tiyaataar).
Ñawuuji tati gadani gonɗi e ƴiiƴam, ɗi safaara mum en ɓuri haawnaade caggal nde neɗɗo ƴetti ƴiiƴam, ko Virus ŋakkere cellal neɗɗo (VIH), Virus Hepatitis B (VHB), e Virus Hepatitis C (VHB), e sara **tetanus (*Clostridium tetani-contamined.or need.do Epidemiyoloji kilinik ummoriiɗo e Fedde Adunaare Cellal (OMS) e nokkuuji toppitiiɗi ko fayti e ñawuuji (CDC, Amerik) ina ndokka goongaaji ɗiɗi teeŋtuɗi : gadanol ngol, ko goonga, mbaawka heɓde VIH ummoraade e ƴiiƴam renndo ngo werlii e henndu yaajndu e nguleeki ina famɗi no feewi (taariindi ina ɓadii surveillance B). ko ɓuri heewde e nguurndam e nder weeyo ; ɗimmo oo, **golle safaara gonɗe e sahaa, teeŋti noon e Prophylaxie Post-Exposition VIH (nPEP) fuɗɗotoonde e nder waktuuji 72 (e ko ɓuri moƴƴude e nder waktuuji 2 haa 24) e Hepatitis B Immune Globulin (HBIG) e ñawu nguu, ina mbaawi haɗde serokonversiyoŋ fotde timmude so ina waɗanaa.
Waɗde ɗum jooni¶
So tawii ko aan walla ɓiɗɗo maa tan ɓuuɓnaa walla ɓuuɓnaama e ƴiiƴam kuutorteeɗam walla werlaaɗam, walla e kuutorgal ɓuuɓngal jooni jooni, waɗ ɗeeɗoo geɗe jeegom ɗoon e ɗoon :
- Lootu nokku punndi oo ɗoon e ɗoon e saabunde e ndiyam ngulɗam fotde hojomaaji 5 haa 10 : Jogaade junngo, junngo, walla koyngal ɓuuɓngal, tawa ina ɓuuɓna ndiyam ɓuuɓɗam walla ngulɗam, lootde no feewi e saabunde ɓuuɓnde. Yoo gaañannde ndee ƴiiƴam e hoore mum tawa ina woni e les ndiyam ngulɗam.
- WOTO MEƊƊU ɓuuɓnude, ɓuuɓnude, ɓuuɓnude, ɓuuɓnude no feewi, walla werlaade bleach walla ɓuuɓnude alkol e nder ɓuuɓri punndi: Woto ɓuuɓnu walla ɓuuɓnu ƴiiƴam sara ɓuuɓri ƴiiƴam ngam "ɓuuɓnude" ƴiiƴam, woto waɗ hunduko maa e ɓuuɓri ndii ngam ɓuuɓnude ɗum, kadi woto werlu udrogenluco e nder galle punndi. Wiɗtooji CDC e UK Health Security Agency (UKHSA) ina kollita wonde ɓuuɓnude walla ɓuuɓnude ina bonna ƴiye kapilaaruuji, ina addana ɗum en ɓuuɓde e nder nokkuuji ɗii, tee ina addana ɗum en ɓuuɓde e nder ƴiiƴam, tawa ina ɓuuɓna ɗum en.
- Loow gite, nofru, walla hunduko e ndiyam laaɓɗam walla saline fotde hojomaaji 15 so tawii ndiyam ina ɓuuɓtoo e nder siriŋ: So tawii ndiyam ummoriiɗam e barme siriŋ ina ɓuuɓtoo e gite maa, e nder ƴiye maa, walla e hunuko maa e nder sahaa nde kewu nguu waɗi ndee, loow gite udditiiɗe ɗee e ndiyam ɓuuɓɗam jokkondirɗam walla saline sterile for%5u ruttaade e ndiyam tawa ɓuuɓnaaki.
- Accu siriŋ mo werlaa oo memotaako walla moɗtu ɗum tan e pinngi e nder butelaaji palastik tiiɗɗi (WOTO recap e junngo): Hoto meeɗ huutoraade koppi maa ɗi ngalaa koppi ngam ustude kaɓirgal palastik e dow ƴiiƴam (recapping ko sabaabu limto-go’o e ɓuuɓri ɗiɗmiri). Tesko-ɗen no siriŋ oo wayi (so tawii ƴiiƴam ɗam ina ɓuuɓna, mbele ƴiiƴam kesam ɓuuɓɗam ina yiyee e nder huɓeere ndee, e mbele ɓuuɓri ndii ina ɓuuɓna). Woɗɗito sukaaɓe woɗɓe e ƴiiƴam, tesko-ɗen wonde cuuɗi cafrirɗi ƴeewtataa siriŋuuji mberlaaɗi ngam ƴeewde so ina woodi mborosaaji sabu ƴeewde heddiiɓe e nokkuuji yoorɗi ko huunde nde alaa ɗo haaɗi e safaara, ina leeltina safaara.
- Yah to Departemaa Emergency walla Urgent Care ɗoon e ɗoon (E nder waktuuji 2 so ina waawi, e dow tiiɗnaare hade waktuuji 72): Woto ɗaɓɓu balɗe ɗiɗi ngam ƴeewde doktoor galle. Yah to Departemaa Emergency to opitaal ngam safroowo waawa ƴeewtaade baasal maa, so tawii ko ko hollitaa, rokka ma dose gadano VIH (PEP) e nder waktuuji 2 haa 72, wondude e ñawu Hepatitis B Immune Globulin Hepatitis a (HBIG), BIG.
- So tawii lekki kii waɗii e golle, humpit gardiiɗo maa e Cellal Golle ɗoon e ɗoon ngam ƴeewde ñawɗo oo: E nder safrirde, e nder safrirde, walla e nokku ɗo ñawɗo oo anndaa ɗoon, haalan ɗum ɗoon e ɗoon so yaawi ƴeewndo antigen/antibiotik VIH jibinannde nayaɓere, antigen hepatitis B surface antibody C can ƴettaa e ñawɗo iwdi oo e yamiroore mum, ko heewi laɓɓinde ma e haajuuji balɗe 28 leɗɗe PEP e nder waktuuji ɗiɗi.
Lajal tiiɗngal waktuuji 72 ngam haɓaade VIH caggal nde neɗɗo heɓi ɗum (PEP)
Ko wiyetee « Prophylaxie post-exposition VIH » (PEP) ina gollira e haɗde mboros o ƴellitaade e nder geese dendritik nokku oo hade mboros oo yahde to ƴiye limfatik diiwaan oo, tawa ina tabitina mboros oo e nder ɓalndu duumotooɗo. Waktu kala ina limtee : PEP ina ɓuri waawde huutoreede so taƴre adannde ndee ɓuuɓnaama e nder waktuuji 2 haa 24 caggal nde ƴiiƴam ɗam ɓuuɓnaa, ina waasa nafoore mum seeɗa-seeɗa e nder waktuuji 48, tee waɗaani nafoore so tawii fuɗɗiima ko ɓuri waktuuji 72 (balɗe 3) caggal nde ɓuuɓnaa. Ɗaɓɓu ƴeewndo safaara ko yaawi ñalnde heen ñawu nguu waɗi.
Triage needlestick e Prophylaxie Post-Exposition (PEP) ƴeewndo kuule¶
Huutoro ndee lekki triage clinique ngam yahde e toppitagol ñawbuuli ko yaawi haa e toppitagol safaara ɓuuɓɗo e ƴeewndo ƴiiƴam fuɗɗorde.
flowchart TD
Prick["Punndi Accidental Needlestick walla Sirinji Ɓoornaaɗi Ina Waɗi"] --> WashNow["1. Ballal gadanal ko yaawi : Loowde no feewi e saabunde & ndiyam ɓuuɓɗam fotde hojomaaji 5 haa 10 ; Yo Ƴiiƴam Ɓooy"]
WashNow --> NoSqueeze["2. WOTO Ƴeew, Kosam, Ɓoornu, Suuɗ, walla Waɗde Bleach/Peroxide e nokku punndi oo"]
NoSqueeze --> SettingCheck{"3. Hol to ƴiiƴam ɗam waɗi?"}
SettingCheck -->|"A. Cellal / Golle (Neɗɗo iwdi Anndaa walla Anndiraa)"| OccReport["Habrirde Gardiiɗo / Cellal Golle Ɗoon e ɗoon ; Yuɓɓinde ƴeewndo jaawngo VIH, HBV & HCV e ñawɗo iwdi"]
SettingCheck -->|"B. Renndo / Park jamaa / Trash (Iwdi mum anndaaka)"| NoteNeedle["WOTO Recap Needle e Juuɗe; Tesko so tawii Hollow-Bore walla Ƴiiƴam Kesam Yiyteteeɗam; Rajo Nokku ngam ƴettude kisal"]
OccReport --> GoER["4. Yah to Departemaa Emergency Hospitaal ɗoon e ɗoon (ina moƴƴi e nder waktuuji 2, tawa ko e les waktuuji 72)"]
NoteNeedle --> GoER
GoER --> PathogenTriage{"5. Departemaa Emergency ngam haɓaade ñawuuji nay & Porotokol laboratuwaar baɗɗo"}
PathogenTriage -->|"Pathogen 1 : VIH"| HIVStep["Sifaade Ag/Ab VIH Jaawɗo Base; Fuɗɗoraade PEP 3-Lekki Antiretroviral balɗe 28 So tawii ko e nder waktuuji 72"]
PathogenTriage -->|"Ñawɗo 2: Hepatitis B (VHB)"| HBVStep["Ƴeewto ngonka Anti-HBs Ɓooyɗo; Hokkude HBIG + HBV Series Vaccin E nder Waktuuji 24 so tawii Faddaaka"]
PathogenTriage -->|"Ñawɗo 3: Hepatitis C (VHC)"| HCVStep["Sifaade mbaydi gonndi e HCV & ALT; Test PCR HCV RNA mo yontere 4 haa 6 (ina safra so yiytaama)"]
PathogenTriage -->|"Ñawɗo 4 : Tetanus"| TetStep["Waɗde Tdap / Td Booster so tawii >Duuɓi 5 Gila Dose Cakkitiinde (Ɓeydu TIG so tawii Faddaaka)"]
Famde caɗeele safaara maa tigi rigi : VIH, Hepatitis B, e Hepatitis C ina nanndi¶
So jibinannde yiyii cukalel ina fiyee e siriŋ e nder parsel walla golloowo ina fiyee e nder saak mboɗeejo, kulhuli ina keewi addande ɗum en miijaade wonde ñawu nguu ina selli. E goonga, humpitooji keewɗi to bannge safaara ummoriiɗi e CDC, OMS, e UKHSA ina kollita wonde mborosaaji gonɗi e ƴiiƴam ina ceerti no feewi e mbaawka mum en wuurde e nder ɓanndu neɗɗo, e saabaade ɗum en e ɓuuɓri ƴiiƴam gootol.
| Patogen | Risk Per-Stick ummoraade e ɓuuɓri anndaandi (ƴiiƴam kesam) | Wuurde e nder weeyo e nder Siriŋ yaajɗo mo werlaa | Ko ɓuuɓri caggal ɓuuɓri (PEP) ina woodi ? | Jaabawol Kilinik juutngol |
|---|---|---|---|---|
| 1. Virus Hepatitis B (VHB) | 6% haa 30% (so tawii iwdi ndii ko HBsAg-poositif e HBeAg-poositif; 1% haa 6% so tawii ko HBeAg-poositif) | Toowɗo (Haa balɗe 7 walla ko ɓuri ɗum) e nder ƴiiƴam yoorɗam e nguleeki suudu walla e nder ɓuuɓri siriŋ. HBV ko mboros ɓurɗo tiiɗde e nder ƴiiƴam e nder weeyo. | EEY (Eɓɓoore mawnde): So a timminii limre 3-dose Hepatitis B e cukaagu maa/mawɗo, aɗa heewi wonde e ñawu nguu. So tawii ko ñawu nguu fawaaka walla ngu alaa ko waawi heen, heɓde Hepatitis B Immune Globulin (HBIG) + ñawu nguu e nder waktuuji 24 (hade balɗe 7) ina waawi haɗde ñawu nguu ko ɓuri 90%. | Ina waawi haɗeede e faggudu e HBIG ; infection chronique jogorɗo huutoreede e leɗɗe antivirales. |
| 2. Virus Hepatitis C (VHC) | 0,2% haa 1,8% (ƴeewndo CDC keso ina hiisa -0,2% e kala lekki perkutane ummoraade e ɓuuɓri ARN-positif HCV) | Moderate (Wakkatiiji haa balɗe keewɗe) nder barme siriŋ udditirɗo ɓuuɓɗo, reenaaɗo e lewru, hay so tawii titer viral ina ustoo no feewi so ƴiiƴam yoorii. | ALAA Lekki PEP ko adii, KONO 98% ina safra: Doktooruuji ndokkaani pills prophylactic ñalnde 1 ngam HCV. E nder heen, ɓe ƴeewtotoo ƴiiƴam maa e test PCR RNA HCV sensible e nder yontere 3 haa 6 ; so tawii a heɓiino ñawu nguu, ñawndugol ñawbuuli (DAAs) ina safra Hepatitis C haa timma e nder ko ɓuri 98% e ñawɓe. | Ina safra haa laaɓa cer e DAA therapy oral jamaanu so nanngaama e jarribooji jokkondire. |
| 3. Virus ŋakkere cellal neɗɗo (VIH) | 0,23% haa 0,3% (ko ina wona 1 e nder 300 haa 1 e nder 435 wonande ƴiiƴam luggiɗam, ɗam ƴiiƴam kesam ummoriiɗam e ñawɗo mo VIH mo safraaka; ko ina wona 0% so tawii ko Community Discarded Needle) | Very Fragile (Minutes to hours): VIH ina heewi ɓuuɓde e yoorde, e ɓuuɓde henndu, e ɓuuɓde naange, e waylude nguleeki. So ƴiiƴam nder ƴiiƴam werlaaɗam yoorii, VIH gonɗo e nguurndam ina ustoo fotde 90% haa 99% e nder waktuuji seeɗa. | EEY (PEP balɗe 28 ngam haɓaade VIH): Fuɗɗaade ƴettude leɗɗe 3 (ko ɓuri heewde e tenofovir/emtricitabine + dolutegravir walla raltegravir) e nder waktuuji 2 haa 72 fotde balɗe 28 ina usta baasal VIH fotde 90%. | E nder ƴeewndo winndereyankeewo kuuɓtodinngo wonande mborosaaji renndo ngo werlaa e nder parkeeji/laabi, mborosaaji VIH tabitinaaɗi ɗii, ko famɗi fof, alaa. |
| 4. Tetanus (Tetanus Kulostridiyum) | Fawii ko e mboros leydi/rust e daartol faggudu | Infinite: Sporeeji bakteriiji tetanus ina nguuri e leydi yaasi, e ɓuuɓri, e ɓuuɓri mbeddaaji coftal ɓalli mberlaaɗi. | EEY (Tdap / Td Vaccin + TIG): Toɓɓere ɓeydoore tooke tetanos (ina heen Globulin Immune Tetanos so tawii meeɗaa faggaade) rokketeeɗe e njillu ɓuuɓngu ina haɗa tetanos 100%. | 100% ina waawi haɗeede e ƴeewndo booster tetanus ko yaawi. |
Geɗe joy kollitooje so tawii ƴiiƴam ko High-Risk vs Low-Risk¶
So a arii e Departemaa Emergency, cafroowo garoowo oo walla karallo ko faati e ñawuuji mborosaaji maa ƴeewto geɗe joy mekanik e ñawu nguu ngam wallitde ma suɓaade so tawii ko balɗe 28 PEP VIH ina wasiyee :
- Aannde Injection Hollow-Bore vs. Solid Sharp:
- Njaajeendi siriŋ hipodermiik hollow-bore (kuutorteendi ngam ƴettude ƴiiƴam walla waɗde leɗɗe e nder ƴiiƴam) ina waɗi lummbirde ndernderiire, baawnde jogaade toɓɓe ƴiiƴam ɓuuɓɗe, ɗe ɓuuɓnaaka e henndu.
- Njoɓdi tiiɗndi (hono njuumri sutura, pinndi sewnde, njuumri tatoo, walla lancet jabet tokooso mo ɓuuɓri) ina jogii ƴiiƴam ɓurɗam famɗude no feewi, ina addana kadi baasal ɓurngal famɗude e mboros o.
- Fresh e yiyngo ƴiiƴam e dow kaɓirgal:
- Mbele ƴiiƴam ɗam waɗi ko e nder leƴƴanɗe walla hojomaaji seeɗa caggal nde ƴiiƴam ɗam yalti e ƴiiƴam neɗɗo (yeru, e nder suudu safrirdu walla ko ɗoon e ɗoon caggal nde neɗɗo yiyi neɗɗo ina waɗa ƴiiƴam e nder suudu safrirdu) ?
- Walla ko siriŋ oo ina ɓooyi, ina ɓuuɓi, ina ɓuuɓi, ina yoori haa laaɓi e nder huɗo walla e ceene park jamaa ? Njaajeendi yoorndi, ɓuuɓndi, gonndi e geɗe yaajɗe balɗe ina njogii VIH mo alaa ko waawi heen, hay so tawii noon haa hannde ina ɗaɓɓi reentaade Hepatitis B e tetanus.
- Luggiɗgol Naatgol e Dille Plunger:
- Ɓoornugol dowri e dow laral toowngal ɓalndu walla rewrude e ŋoral paɗe kaɓirgal teddungal, ngal alaa ko waawi heen wonde so wonaa ɓuuɓnude ƴiiƴam, ina famɗi no feewi e ŋoral luggiɗngal e nder ɓalndu ɗo ŋoral siriŋ ina ɓuuɓna e nder ŋoral.
- Barrier gannde walla paɗe:
- So ƴiiƴam rewii e gannde safaara lateks/nitril walla e sole rubber/canvas sneaker hade mum fiyde ɓalndu, huunde tiiɗnde ndee ina moofta 50 haa 86 e nder teemedere ƴiiƴam heddiiɗam e yaasi ƴiiƴam ƴiiƴam ɗam.
- Anndaa vs. Anndaaka iwdi ngonka:
- So tawii neɗɗo iwdi oo ina anndaa, ina jogii mboros VIH mo yiytaaka e nder safaara antiretroviral, walla so tawii ƴeewndorɗe VIH jaawɗe, jibinannde nayaɓere, PEP ina waawi dartineede e kisal.
Ko kewata e Departemaa Emergency : Porotokol kilinik waktu-waktu¶
Anndude hol jarribooji e safaaraaji ɗi potɗaa ɗaminaade, e ko naamnotoɗaa so tawii aɗa yilla to safrirde toppitiinde ko yaawi, ina addana-ma hoolkisaade wonde hay feere ndeenka woodaani e njillu maa e nder njillu maa.
Ɗatal 1: Triage ko yaawi (Haaldu e biro yeeso "Feññinde ƴiiƴam: Wakkati sensible ngam PEP")¶
So aɗa ƴeewndotoo e Departemaa Emergency to opitaal, woto wiy tan "Mi taƴii huunde tiiɗnde." Haala laaɓndal e infirmiye triage: **"Mi heɓiino mboros e nder ƴiiƴam kuutorteeɗam [X] minitaaji seeɗa ko adii jooni, miɗo haani ƴeewteede e sahaa ngam anndude VIH e Hepatitis B Protokol VIH e Hepatitis B." ina teskaa ngam dose gadano fuɗɗorde leɗɗe antiretroviral ina waawi rokkireede e nder suudu safrirdu walla suudu ƴeewndo e nder hojomaaji 60.
Ɗatal 2: Ƴeewndo ƴiiƴam (Ƴeewndo ñalngu 0)¶
Ko adii walla ɗoon e ɗoon so a ƴettii dose maa gadano PEP, goomu safrooɓe oo maa ƴettu Baseline (Day 0) labs ƴiiƴam. Hol ko waɗi ƴeewndo ñalnde 0 nde ƴiiƴam ƴiiƴam ummoraade e waktu gooto ɓennuɗo waawaa feeñde e ƴiiƴam maa tawo?
- Teskuyaaji baɗɗiiɗi ina kollita ngam binnditagol njoɓdi safrooɓe e gollotooɓe wonde aɗa alaa e VIH, Hepatitis B, e Hepatitis C e sahaa nde ngañgu-ɗaa ndee.
- Kadi ina ƴeewtoo tiitoonde maa Antibiotik hepatitis B (anti-HBs) (ngam hollirde so tawii ñawbuuli cukaagu maa ina ndeena ma haa jooni) e ƴeewde mbaydi maa golle ƴiiƴam (kreatinin/eGFR) e enzim heeñere (ALT/AST) ngam doktoor oo waawa winndude PEPgimen 28-day e dow jam.
Ɗatal 3: Njuɓɓudi 3 safaaraaji Prophylactic e njillu nguu¶
- Reende Hepatitis B (Cakkital e/walla HBIG):
- So tawii aɗa fawanoo ko adii ɗuum, aɗa jogii kaayitaaji (anti-HBs e 10 mIU/mL walla ko ɓuri ɗum): Alaa ko haani safrude Hepatitis B.
- So tawii a fawaaki, a fawaaki haa timmi, walla a anndaa ngonka maa: Doktoor oo maa rokku ma doosgal gadanal ngal faggudu Hepatitis B ɗoon e ɗoon e nder ɓalndu maa deltoid (rewi heen ko doseeji e lebbi 1 e 6) e, wonande ƴiiƴam ɓurɗam heewde baasal, injection B**Hepatitis, anticorps passifs ngam ustude mboros oo ɗoon e ɗoon tawa ɓanndu maa ina maha jaabawol mum e ñawu nguu.
- Profilaksi VIH caggal nde neɗɗo heɓi ɗum (Regime oraal balɗe 28):
- E nder jamirooje CDC, OMS, e Fedde VIH Angalteer (BHIVA) hannde, njuɓɓudi nPEP ɓurndi moƴƴude wonande mawɓe e sukaaɓe ko leɗɗe tati gonɗe e hunuko, ƴettaaɗe laabi tati ñalnde kala, fotde balɗe 28 timmuɗe: ko ɓuri heewde ko somarabirita /Tenovirilm (TDF/FTC, walla TAF/FTC)** ina hawra e ɓuuɓri gonndi e ɓuuɓri, ko wayi no Dolutegravir (DTG) walla Raltegravir (RAL) (walla ɓuuɓri gonndi e taƴre wootere hono Biktarvy e nder departemaaji keewɗi e nder safaara).
- Tabitin a yalta Departemaa Emergency e "Starter Pack" e junngo: Farmasiiji opitaal ina keewi rokkude balɗe 3 haa 7 balɗe PEP pills to junngo maa hade maa yaltude damal ngam waasde majjude waktuuji 24 ngam faddaade koɗki ngam yamirde retail pharma a.
- Haɓde e ñawu Tetanus:
- Sabu ƴiye mberlaaɗe e laabi, e parkeeji, walla e nokkuuji ɓuuɓɗi ina mbonna, aɗa heɓa Tdap walla Td tetanus booster so tawii ko ɓuri duuɓi 5 ko ɓuuɓri tetanus maa cakkitiindi.
Njuɓɓudi leɗɗe PEP VIH balɗe 28 e heɓde ballal kaalis¶
Wonande ñawɓe ɓe ndokkaa ñawu nguu balɗe 28, ko ɗooftaade ɗum woni ko ɓuri teeŋtude e teskaade nafoore safaara oo. Doseeji jokkondirɗi ŋakkuɗi e nder yontereeji ɗiɗi gadani ɗii ina addana mbayliigu viral fuɗɗaade hade cellal nokkuyankeewal gonngal e ñawu nguu maayde e sifaa mum.
No njiyru-ɗaa batte PEP keewɗe tawa aɗa woppa pills maa¶
Rejimuuji PEP gonɗi e reentaade integrase (hono TDF/FTC e dolutegravir walla raltegravir) ɓuri newaade no feewi e rejimuuji ɓooyɗi reentorɗi protease e kitaale 1990, sibu ko ina ɓura 90 e nder teemedere ñawɓe ina timmina balɗe 28 timmuɗe tawa ɓe ngoppaani. Kono tan, batte ɓuuɓɗe ina mbaawi heɓtaade e nder balɗe 4 haa 7 gadane ɗee :
- Nausea Mild walla Stomach Upset: Ƴettu tablet maa PEP ñalnde kala e ñaamde seeɗa walla e ñaamde seeɗa tawa ko e reedu ɓuuɓndu, naamndo cafroowo departemaa emergency ngam rokkude ma lekki juutki ngam haɓaade nausea (hono ondansetron) ngam jogaade e galle so tawii ko huunde nde alaa ko waawi. So a ɓuuɓtii e nder waktu 1 caggal nde ɓuuɓɗaa pillol PEP maa, ƴettu dose goɗɗo ɗoon e ɗoon ; so a ɓuuɓtii ko ɓuri waktu 1 caggal nde ɓuuɓɗaa, lekki kii ina ɓuuɓna, aɗa fotaani ruttaade e dose.
- Jokkondire hakkunde leɗɗe e miniraaji (Ansid, Kalsiyum, Njamndi, e Magnesiyum): Inhibiteeruuji integrase hono dolutegravir e raltegravir ina njokkondiri e kemikal e katyon njamndiiji keewɗi (kalsiyum, magnesiyum, aluminium, e njamndi) e nder ƴiiƴam maa, ko ɗum haɗata ƴiiƴam VIH e nder ƴiiƴam maa. Woto meeɗ muñde pillol PEP maa e sahaa gooto e karbonaat kalsiyum (Tums/Rolaids), antacid magnesium/aluminium, ɓeydaare njamndi, walla multivitamin. Ƴettu tablet maa PEP ko famɗi fof waktuuji 2 ko adii walla waktuuji 6 caggal kala antacid, njamndi, walla miniraal.
- Ko mbaɗata so a ŋakkii dose: So a yejjitii pillol maa ñalnde kala, ƴettu ɗum e sahaa mo ciftorto-ɗaa so wonaa tawa ko waktuuji dose maa potɗo arde oo yontii; hoto meeɗ ƴettude dose ɗiɗi e sahaa gooto ngam ustude pillol ngol ŋakki.
No keɓirten balɗe 21 haa 25 heddiiɗe ɗee e pills PEP yoɓaaɗe¶
So tawii suudu safrirdu rokkii ma paaspoor fuɗɗorde balɗe 3 haa 5, woto ɗaɓɓu haa Ñalawma 5 ngam heblude heddiiɓe e restoraaji maa balɗe 28, sibu farmasiiji tokoosi ina njogii sahaaji waktuuji 24 ngam yamirde leɗɗe keertiiɗe :
- Nokkuure gollorde walla cellal: Ko 100 e nder teemedere (100%) e njoɓdi zero yaltundi e poosi e Njoɓdi gollooɓe e porogaraam golloowo maa ngam cellal gollorde ƴiiƴam e nder sariya fedde (OSHA 29 CFR 1910.1030 e nder leydi Amerik, kuule HSE).
- Needlesticks renndo e nder leydi Biritaan, Kanadaa, UE, e Ostarali: Ina rokka ɗum tawa yoɓaani (walla ko yowitii e co-pay) rewrude e Departemaaji NHS Emergency e kilinikuuji Cellal Jokkondiral / GUM (UK), opitaaluuji cellal renndo e nder diiwanuuji (Kanada), walla farmasiiji opitaaluuji renndo.
- Nyawɓe ɓe ngalaa asiraagal walla ɓe njoɓata ko heewi e nder leyɗeele dentuɗe Amerik: Kaayitaaji copay peewnoowo (Gilead Advancing Access e ViiV Connect), porogaraamuuji PEP ɗi ngalaa asiraagal / ADAP, e kilinikuuji cellal renndo municipaal ina ndokka kursuuji PEP e nder balɗe 28 e dow njoɓdi zero wonande ɓe ngalaa asiraagal renndo ngo.
Ardorde teeŋtunde wonande jibnaaɓe so cukalel ngel ɓuuɓnaama e siriŋ werlaa¶
Yiytude wonde cukalel tokosel walla cukalel jahroowo e duuɓi 18 ƴettii siriŋ e nder pijirlooji, e nder ladde, walla e nder suudu safrirdu renndo, ina hulɓinii kala jibinannde. Annduɓe ñawuuji sukaaɓe ina wasiyoo ɗeeɗoo geɗe keertiiɗe e sukaaɓe :
- Deƴƴu mbele ɓiɗɗo maa ina haalana ma goonga ɗo ƴiiƴam ɗam memi ɓe: So jibinannde ina hulɓinii walla ina wulla e cukalel ngel ƴetti ƴiiƴam e nder parsel, sukaaɓe tokosɓe ina keewi hulde heɓde caɗeele, ina njedda wonde ƴiiƴam ɗam ina ɓuuɓna ɓalndu mum en. Haaldu e daande welnde, deeƴnde, deeƴnde: "A alaa e caɗeele hay dara, kadi a waɗii golle mawɗe e haalande mi. Hollu am hol koppi memi ɗum mbele mbaawen lootde ɗum e ndiyam."
- Ƴeewto koppi, paɗe, koyɗe, e les sneaker les annoore jalbunde: Ƴeewto no feewi juuɗe e koyɗe cukalel ngel ngam yiytude kala toɓɓere pinpoint boɗeere tokosere walla ɓuuɓri. Kadi wirno paɗe cukalel ngel, ƴeewto-ɗaa so tawii ko ɓuuɓri gonndi e ɓuuɓri ndii, ngam anndude so tawii ɓuuɓri gonndi e ɓuuɓri ndii ina jokki haa jooni e nder ɓuuɓri ndii.
- Nafoore Hepatitis B sukaaɓe: Sabu baɗte Hepatitis B cukalel ngel e nder winndere ndee ina jeyaa e ko ɓuri heewde e baɗte baɗte sukaaɓe gila e kitaale 1990 e nder ko ɓuri heewde e leyɗeele, ko ɓuri heewde e sukaaɓe baɗte ina njogii tawo ko ina wona jooni duuɓi 100, ko ina wona 100 000 mbuuɗu ina mbaawi haɓaade ñawu nguu, tawi ko ɓuri heewde e mum en ina njogii mborosaaji baawɗi haɓaade ñawu nguu. So tawii ɓiɗɗo maa ina yamiraa PEP VIH sukaaɓe, farmasiiji safrirde ina mbaawi rokkude sukaaɓe tokosɓe ɓe mbaawaa muñde pills mawɓe, suspensions liquides baɗɗi teddeendi, tablette dispersible, walla formulations chewables.
Rewde limngal ƴeewndo ƴiiƴam e timminde jaŋde maa PEP balɗe 28¶
Caggal nde njaltuɗaa e suudu safrirdu, ndeenka maa safaara fawii ko e geɗe ɗiɗi : timminde balɗe 28 ɗe leɗɗe maa PEP ɗee kala tawa aɗa ƴakka doosɗe (so tawii PEP VIH ina yamiraa) e timminde ƴeewndo ƴiiƴam maa jogorngo rewde ngam heɓde 100 e nder teemedere "All Clear."
Waktuuji jarribooji laboratuwaaruuji caggal-needlestick¶
| Toɓɓere Wakkati Caggal Leggal | Teskuyaaji ƴiiƴam mbaɗaama | Faandaare Ngolɗoo Ƴeewndo |
|---|---|---|
| Nyannde 0 (Njillu Jaɓɓungal) | VIH-½ Ag/Ab mo yontaaji 4; Hepatitis B gonɗo e dow leydi (HBsAg) & Antigen gonɗo e dow leydi (anti-HBs); Hepatitis C (ko haɓata e VHC) ; Kreatinin e ƴiiƴam ALT | Ina tabitina ngonka bonka e fuɗɗoode, ina hoolkisa cellal ƴiiƴam/heeñere ngam pills PEP, ina ƴeewa kadi immuniteer gonɗo e ñawu Hepatitis B. |
| Aset 2 (Nyalawma 14) (So aɗa ƴetta PEP VIH) | Ƴeewndogol e nder safrirde; Fuɗɗito-ɗaa e mbaydi mbaylaandi (Kreatinine) e golle heeñere (ALT/AST) so tawii ko e nder safrirde holliti | Ƴeewto so tawii aɗa muñana taƴe PEP ɗee no moƴƴi, kadi aɗa jogoo kala ɓuuɓri walla ɓuuɓri seeɗa mbele aɗa timmina balɗe 28 ɗee kala. |
| Aset 4 haa 6 (Lebbi 1 haa 1,5) | Ag/Ab VIH 4ɓo (ina ɓeydoo heen ARN VIH so tawii maale ɗee ina ngoodi) E Test PCR RNA HCV keewɗo | Laɓɓingol ko yaawi teeŋtungol : Test PCR RNA HCV e nder yontere 4 haa 6 ina yiytoo mboros Hepatitis C to bannge 100% ; ARN HCV mo moƴƴaani e yontere 4 haa 6 ina haɗa Hepatitis C fotde no feewi. |
| Lewru 3 (Aset 12) | Laboratoori 4ɓo VIH-½ Ag/Ab | Laɓɓingol VIH timmungol (Standard): E nder ƴeewndo laboratuwaar antigen/antibiotik mo yonta 4ɓo, ƴeewndo bonngo e yontereeji 12 (lebbi 3) caggal nde neɗɗo heɓi (ɗum woni jonte 8 caggal nde o timmini kursus PEP balɗe 28) ina hiisee wonde ko timmuɗo wonande cellal VIH e UKuthorities e ko ɓuri heewde e mum en. |
| Lewru 4 haa 6 (Aset 16 haa 24) | Antibiotik anti-HCV cakkitiiɗo, HBsAg (so tawii o fawaaka e fuɗɗoode), e Ag/Ab HIV cakkitiiɗo (so tawii ko porotokol nokku golle OSHA Amerik ɗaɓɓiri ɗum) | 100% Ƴellitaare Cafrirde Gadiinde: Ina hollita ŋakkeende timmunde e serokonversiyoŋ VIH, Hepatitis B, e Hepatitis C. |
Reentaade e nder yontere 6 haa 12 nde rewindaade¶
Nde ngon-ɗaa e ɗaminaade ƴeewndo maa sakkitiingo e nder laboratuwaar, annduɓe ñawuuji mborosaaji ina wasiyoo ma waɗde feere nayi laaɓtuɗe (hay so tawii noon mbaawka maa heɓde ñawu nguu ina famɗi no feewi) :
- Woto ndokku ƴiiƴam, plasma, terɗe, ƴiiƴam, walla ƴiiƴam haa nde ƴeewndorɗe maa cakkitiiɗe ɗee kollitii wonde a alaa rafi.
- Naftoro barrier protection (kondom) wakkati jokkirgol bee soobiraaɓe haa limngal maaɗa timma nder asaweeje 12.
- Woto renndin ƴiye, ƴiye, ƴiye, walla ƴiye e yimɓe galle.
- Haalde kala nguleeki nannduki e grippe, ɓuuɓri limfatik, ɓuuɓri gonndi e daande, walla ɓuuɓri ƴiiƴam ɗoon e ɗoon: So tawii a heɓii ɓuuɓri, ɓuuɓri ɓanndu, walla ɓuuɓri gonndi e daande tawa a faamaani hakkunde yontere 2 e yontere 8 caggal nde njiyɗaa ƴiiƴam, noddu ɗoon e ɗoon safrirde maa toppitiinde ƴeewndo viral HCV RNA e RNA VIH jaawɗo.
No seertirtee walla ustirtee siriŋ tawaaɗo e nder parsel walla e nokku golle e nder kisal¶
So tawii a tawii siriŋ werlaa e nokku pijirlooji, e dow maayo, e saraaji laawol, walla e nder suudu safrirdu jamaa, walla caggal nde neɗɗo fiyi, haɗde neɗɗo ɗiɗaɓo ɓuuɓde ina tiiɗi.
Ko waɗi a meeɗaa werlaade siriŋ loowdi e nder saak mbaylaandi walla e nder laylaytol mbaylaandi
Wertude ƴiiƴam ɗam alaa ko woni e mum e nder saak mbuuɗu renndo walla e nder saak mbuuɗu galle ina ɗaɓɓi nde ƴiiƴam ɗam ɓuuɓtata e nder saak ɓuuɓɗo oo, ina fiytoo golloowo e saak oo, walla gardiiɗo galle oo, walla tergal galle ngal, ƴettuɗo saak oo e koyngal mum en caggal ñalngu nguu.
Porotokol jokkere enɗam 4-Step¶
- Cuɓal ɓurngal moƴƴude e nder nokkuuji/laabi jamaa (Woto memo ɗum: Gardiiɗo & Noddu 311 / Non-Emergency): So tawii a alaa kuutorɗe ndeenka tawa hay gooto alaa e sago taƴa heen, hokku mawɗo gooto daraade meeteruuji 2 (6,5 feet) ngam haɗude sukaaɓe e pucci canill yourgen-1. e nder Amerik e Kanadaa, cellal nokkuuji e nder leydi Angalteer/Ostarali) walla gardiiɗo park ngam waɗde ƴettugol ƴiye biohazard.
- So tawii ko maa njiylo-ɗaa Siring oo ɗoon e ɗoon ngam reende sukaaɓe:
- Woto meeɗ meemde tip njuumri ndii kadi woto meeɗ etaade waɗde kaɓirgal caggal njuumri ndii.
- Adda **kosam ɓuuɓɗam, ɓuuɓɗam, ɓuuɓɗam, ɓuuɓɗam, ɓuuɓɗam, ɓuuɓɗam, ɓuuɓɗam, ɓuuɓɗam ɓuuɓɗam, ɓuuɓɗam ɓuuɓɗam, walla ɓuuɓɗam ndiyam/soda HDPE (woto meeɗ huutoraade jardugel gilaas, baawɗo ɓuuɓnude e sosde gilaas, never e biohazard aluminium ina waawi).
- Waɗde, waɗtu lowre palastik udditiinde ndee fotde e leydi bannge ñaamo sara siriŋ (woto meeɗ jogaade lowre ndee e junngo maa nano tawa aɗa ɓuuɓna heen ƴiiƴam e junngo maa ñaamo, walla aɗa fija e junngo maa nano so a ronkii udditde).
- Huutoro pinse, pinngi kuɓeeje, pinse, walla karton / dustpan ɗiɗi tiiɗɗi (ɓoorno-ɗaa gannde gollorde ɓaleere tiiɗnde walla gannde diƴƴe kaɓirɗe so ina woodi) ngam ƴettude siriŋ oo e dow plunger/barrel end plastik tawa ŋoral ŋoral ŋoral ina toɗɗii ɓanndu maa.
- Ɗaɓɓu siriŋ toɓɓere-toɓɓere-arannde e nder butelaaji palastik tiiɗɗi gonɗi e leydi, ɓuuɓna kaɓirgal ngal no feewi, ɓuuɓna kaɓirgal ngal e laylaytol teeŋtungol, winndu **"WOTO RECICL: BIOHAZARD SHARPS suudu safrirdu sharps binndi, walla nokku ɗo mbuuɗu bonɗo municipaal.
Naamne keewɗe naamneede¶
Mbele miɗo foti ɓuuɓnude junngo am ngam ɓeydaade ɓuuɓde walla mi werloo heen ɓuuɓri caggal nde ɓuuɓnu-mi?¶
Alaa, a fotaani meeɗde ɓuuɓnude, ɓuuɓnude, ɓuuɓnude, walla ɓuuɓnude ɓuuɓri ɓuuɓri, kadi woto meeɗ waɗde kemikaaji bonɗi ko wayi no ɓuuɓri galle, peroksiid hidrojen, walla alkol ɓuuɓnoowo mo ɓuuɓnaaka. Wiɗtooji safaara ɗi CDC e OMS mbaɗi ina kollita wonde ɓuuɓnude walla ɓuuɓnude ina ɓuuɓna ƴiiƴam ɓuuɓɗam, ina addana ɗum ɓuuɓri gonndi e nokkuuji ɗii, tawi noon, e goonga, ina addana ƴiiƴam ɗam ɓeydaade luggiɗde e nder ƴiiƴam, tawa ina yaltina ɗum en. E nder ɗuum, jogaade nokku punndi oo e les ndiyam ɓuuɓɗam, lootde ɗum no feewi e saabunde fotde hojomaaji 5 haa 10, tawa kala ƴiiƴam naftoojam ina yalta e hoore mum.
Mbele miɗo foti addude siriŋ mo mberlaa oo e am to suudu safrirdu too mbele safrooɓe ina mbaawa ƴeewndaade ɗum so tawii ina woodi VIH ?¶
Alaa, jamirooje safaara ummoriiɗe e CDC, OMS, e renndooji safaaraaji caɗtuɗi ina wasiyoo laaɓndal yo addude siriŋ renndo tawaaɗo e nder departemaa cafrirɗo ngam ƴeewndaade mborosaaji. Hoolkisaade heddiiɓe yoorɓe walla mikroskoop e nder siriŋ taariindi ko huunde nde ganndal hoolnaaki (toɓɓere fenaande-negatif toownde), ina bonna waktuuji caɗtuɗi e nder faddaade ƴeewndorɗe laboratuwaar ɗe ngonaa njuɓɓudi, ina addana kadi baasal mawngal e jogaade infirmiyee, doktoor, walla hoore maa e nder yah-ngartaa. E nder ɗuum, ƴettu tan foto ƴiiƴam ɗam e nokku mo alaa ko woni e mum so wonaa kisal walla siftor so tawii ko ƴiiƴam ɗam ɓuuɓɗam, so tawii ƴiiƴam kesam ɓuuɓɗam ina yiyee e nder mum.
Hol no ɓiɗɗo am waawi heɓde VIH caggal nde taƴi walla memi ƴiiƴam werlaaɗam e nder park walla e nder maayo ?¶
So tawii kala ɓuuɓri ƴiiƴam werlaa ina ɗaɓɓi ƴeewndo ko yaawi e nder suudu safrirdu, jibnaaɓe ina mbaawi heɓde cuusal mawngal e nder doosɗe ganndal : VIH ko mboros bonɗo no feewi, mo maayata ko yaawi so tawii ko e henndu yaajndu, e yoorde, e lewru. E nder duuɓi capanɗe jeegom ɗi CDC, Public Health Agency of Canada, e UKHSA mbaɗi caggal ujunnaaje ujunnaaje sukaaɓe ɓuuɓɓe e ƴiye mberlaaɗe e nder parkeeji, e nder nokkuuji pijirlooji, e nder beeli, keewal mboros VIH tabitinaaɗo ummoraade e ƴiye mberlaaɗe e nder renndo yaajngo ina famɗi no feewi. Ko ɓuri teeŋtude e safaaraaji e njillu nguu ko hoolkisaade ndeenka ɓiɗɗo maa e faggudu Hepatitis B e Tetanus e fellitde e safroowo sukaaɓe so tawii PEP ngam haɗde ɗum ina foti.
Hol no foti waktuuji caggal nde njiy-mi ƴiiƴam, pot-mi fuɗɗoraade ƴeewndo VIH (PEP) ?¶
Aɗa foti fuɗɗoraade ƴettugol VIH (PEP) e nder waktuuji 72 (balɗe 3) caggal nde ƴiiƴam ɗam ƴettitaa, tawa kadi ko ɓuri moƴƴude ko e nder waktuuji 2 haa 24 gadani ɗii. Leɗɗe PEP antiretroviral ina ngolloo e haɗde mboros o ƴellitaade e nokku punndi nokku oo hade mum yettaade ƴiiƴam maa ; kala waktu ko adii nde njuumtataa pillol gadanol ngol ina ɓeyda semmbe mum, kadi fuɗɗoraade PEP caggal waktuuji 72 ina addana ɗum nafoore seeɗa walla alaa ko nafata.
Fuɗɗoode ƴeewtaama¶
- Centres de Contrôle et de Prevention des Maladies (CDC) e Sarwiis Cellal Jaaɓihaaɗtirde Amerik (Amerik): Kuule Sarwiis Cellal Jaaɓihaaɗtirde Amerik kesɗitinaaɗe ngam ƴellitde ñawbuuli e nder golle e wasiyaaji ngam haɓaade ñawuuji caggal nde neɗɗo heɓi ɗum, PEP mo alaa ko woni e mum e PEP mo wonaa golle (nPEPline Gupatitis of BEP) Caggal nde Feññinaa.
- Fedde Adunaare Cellal (OMS): Kuule kuuɓtodinɗe ngam haɓaade VIH caggal nde neɗɗo heɓi ɗum (PEP) e kuutorɗe OMS ɓurɗe moƴƴude ngam haɓaade inɗe e peeje jowitiiɗe heen.
- Fedde kisal cellal leydi Angalteer (UKHSA) e Fedde VIH to Angalteer (BHIVA, Angalteer): Laabi leydi Angalteer ngam huutoraade VIH caggal nde neɗɗo heɓi ɗum e ƴellitde ñawu nguu e nder renndo e nder nokkuuji cellal.
- Njuɓɓudi kisal e cellal golle (OSHA) e NIOSH (Dowlaaji Dentuɗi Amerik): Njuɓɓudi ñawbuuli gonɗi e ƴiiƴam (29 CFR 1910.1030) e kampaañ dartinde leɗɗe.
- Fedde sukaaɓe Kanadaa (CPS, Kanadaa) e opitaal sukaaɓe laamɗo Melbourne (Ostarali): Laabi gollorɗi safaara: njuɓɓudi ñawanɗe ƴiiƴam renndo e nder sukaaɓe.