Formulation of Guidelines

An example of good practice is contained within the UK Health Department's 1998 document (1) which states: "that it is the responsibility of Health Authorities, Health Boards and NHS Trusts to create their own local guidelines to prevent the spread of BBVs in the health care setting." Such guidelines may not exist in other work places. If this is the case, then they should be formulated as soon as possible. Forensic physicians working for the Metropolitan Police in London can refer to the "Good Practice Guidelines" (4). It is also prudent to prearrange a system of referral with the nearest hospital that has an accident and emergency department, a genitourinary department, and access to a specialist. The latter may be a consultant in virology, microbiology, infectious diseases, or genitourinary medicine. Similar guidance in the United States can be found in the Guideline for Infection Control in Health Care Personnel (5).

Most exposures to staff usually result from a failure to follow accepted practice; however, accidents can happen no matter how much care is taken. All forensic physicians and other health care professionals working in custody should understand what constitutes a risk. This involves taking a detailed history of the incident, including the type of exposure, the body fluids involved, and when the incident occurred.

This information can help to allay unnecessary anxiety from the outset and ensures that the victim is referred, if appropriate, to the designated hospital at the earliest opportunity. Knowledge of precise treatment protocols is not required, but it is helpful to be able to explain to the victim what to expect. For example, he or she will be asked to provide a voluntary baseline blood sample for storage and numerous follow-up samples for testing depending on the nature of the exposure. This is especially relevant for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Occasionally, it may be necessary for samples to be obtained as long as 6 mo after the incident.

Sexual assault victims should ideally be referred to specialist centers, if available. A police station should be used only as a last resort because the environment is often hostile and there is no ready access to the necessary treatment and ongoing management (see Chapter 3).

Beat The Battle With The Bottle

Beat The Battle With The Bottle

Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.

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