Resident Clinical Workplace Injury

I've been exposed to blood or body fluids (e.g. needle-stick injury).

If you've experienced a workplace injury, especially if it involves potential exposure to infectious disease, timing is critical. The DFCM Resident Safety Guideline provides protocol for workplace exposure/injury. 

Appendix 2: Protocol for Workplace Exposure/Injury

View the protocol diagram.

Workplace injury/accident:

a) Daytime hours at Affiliated Hospital:

  1. Trainee informs immediate supervisor and site director and reports to Occupational/Employee Health Office
  2. Occupational Health protocol followed, incident report completed, copy to DFCM Program and PGME Office

b)  Training site outside GTA, no Employee Health Office or evening or weekend hours:

  1. GO TO NEAREST EMERGENCY ROOM.  Identify self as PG trainee and ask for immediate assistance.
  2. Report incident to immediate supervisor and site director, complete incident report form as per institution protocol; send copy to DFCM Program and PGME Office

Blood and Body Fluid Exposure Policy and Procedural Guidelines

The Blood and Body Fluid Exposure Policy for University of Toronto Postgraduate Medical Trainees provides procedural guidelines  (PDF) for occupational exposure to blood and/or body fluids:

Action Responsibility

1) Know your immune status to the Hepatitis B Virus (HBV). 

Medical trainee

2) Apply first aid: allow the wound to bleed freely. Wash wound and skin sites which have been in contact with blood or body fluids with soap and water; mucous membranes should be flushed with water. A tetanus shot may be required if the injury is deep and significant time has lapsed since the last tetanus booster. 

Medical trainee

3) Note details of occupational exposure, i.e. type of injury, underlying disease(s) of source, past medical history, risk factors for blood borne pathogen infection.

Medical trainee, hospital’s occupational health or delegate, depending on particular hospital’s protocol

4) Report immediately to hospital’s Occupational Health Service or delegate, e.g.: the Infectious Disease consultant, Emergency Department, or the appropriate hospital administrator depending on the hospital’s protocol.

Medical trainee

5) History-taking and assessment of risk, e.g.:
(a) by characteristics of source, for example: high risk source includes known positive patients with HIV, HBV, HCV and patients at epidemiologic risk of HIV, HBV, HCV
(b) by nature of exposure: for example, high risk exposure would be deep percutaneous injury with hollow bore needle which had been in blood vessel of source
(c) by susceptibility of trainee, for example: not immune to HBV.

(a) and (b): Hospital occupational health or delegate.

(c): Medical trainee

6) Management of follow-up including counseling, baseline and follow-up serology and post-exposure prophylaxis as required. 

Hospital occupational health or delegate

7) Report incident to Postgraduate Office.
Report incident to Site Program Director/Administrator.
Report incident to DFCM.
Report incident to: WSIB (according to WSIB directives)

Hospital occupational health or delegate
Medical trainee
Site Program Director/Administrator
Postgraduate office or hospital occupational health, depending on employer of record