Potentially Infectious Exposure
Step 1: Watch video - Exposure Management 101 or download PowerPoint
Step 2: Print and follow the steps: Exposure Response Outline
Step 3: Contact your Primary Agency. Agency Assignment List
Provide your name and two call-back numbers. You should receive a call back from the Infection Control Liaison (ICL) within 15 minutes. If no call is received after 15 minutes, call them back.
Step 4: Complete the KCEMS Exposure Worksheet (tip: read the back)
Step 5: Review exposure with the ICL. State Exposure Management Document
Step 6: If there is a reasonable risk of exposure, you will be asked to complete some additional paperwork . Fax the completed Exposure Worksheet and the appropriate PA form to the ICL.
If the source patient went to jail use:
Exposure Worksheet - KCEMS EXPOSURE WORKSHEET (E).docx
State Form - PA-57 Dch-1169(E).doc
Reference Statute - PA 57 MCL 333.5204.pdf
If the source patient went to the hospital, the morgue, a funeral home or was not transported use:
Exposure Worksheet - KCEMS EXPOSURE WORKSHEET (E).docx
State Form - PA-419 Dch-1179(E).doc
Referenced Statute - PA 419 MCL 333.20191.pdf
Step 7: The ICL will utilize some additional guides to provide proper notifications and to send documents where they need to go. You should receive a call back from the hospital within 1 hour, if the patient went to the hospital. If they went elsewhere (jail, no-transport, funeral home, etc. it will likely take longer than 1 hour) If you are an ICL and need the secure forms, click here to log in.