Risks of bloodborne diseases to emergency personnel in traumatic wound management

High prevalence of viral hepatitis, increasing HIV infection and other bloodborne diseases in Taiwan have made the health care provider exposed to an increased risk of disease transmission unless adequate precautions and protections have been undertaken. Furthermore, emergency personnel must face the patient with limited information, and neither a reliable predictor nor appropriate tools have been found to assist in identifying emergency patients who pose a risk. The Centers for Disease Control (CDC) in the United States thus issued a specific caveat advocating all body fluids should be treated as potentially infectious under uncontrolled emergency circumstances. Unfortunately, in Taiwan, personnel in emergency service practice with limited protection, often without mask and only gloves as the only barrier device used. We tried to determine the risk of facial exposure during traumatic wound management. One hundred and fifteen wounds of 107 patients were enrolled. Most of them were not life-threatening and thus could be managed under more controlled conditions. Standard procedures of wound management were applied and facial exposure was assessed after each wound closure. Positive exposure rate in such controlled conditions remained as high as 46/115 (40%). Exposure rate in uncontrolled conditions should be, therefore, much more significant. Therefore, we should put more emphasis on adequate precaution and protection against bloodborne diseases.