SANE NURSES ! re Hepatitis B

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    Does any SANE program out there have a risk assessment screening for Hepatitis B? Do you give HBIG or the 1st series of the vaccine if the patient has not be vaccinated? Or do you draw a titer and have them follow up in the clinic?

    Most rapes are date rapes or aquaintance rapes. Even though the victim knows the assailant she rarely knows HIV or Hep B/C status or how many sexual partners he's had which will put her at greater risk.

    The CDC recommends everyone be vaccinated for Hep B. Especially victims of Sexual Assault. However, HBIG and Hep B series is rarely given in our ER. Just wondering if anyone has a protocol re. this?
  2. 4 Comments so far...

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    I know nothing of ER and rape protocol, but if it were me and I wasn't immunized for Hep b, I sure would want to be assessed accordingly. I would think each hospital has a P&P for it or not for it. Sorry, I have nothing! Luckily, in our OB triage, rape is very rare for pregnant women. Good thing too. So rare, in fact, that I have never seen it. But if it did walk in the door, you can be sure, thanks to you, I will bring it up with the doc when it does happen.
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    we have them follow up at a clinic for hep b or hiv. per our policy if we can't provide follow up and counseling for results, we don't do these tests.
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    We only give the first series of the vaccine or HIV prophylaxis treatment if the rape victim knows her accuser and he is in a high risk group (IV drug user, man who has sex with men, etc.) or if the man is a stranger to her, in which case we assumne he's high risk. We draw blood for a titre and have them follow up with their doctor or the public health unit for HepB, C and HIV testing if the woman knows her assailant and he is not classified as high risk.
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    We also refer all of our victims to the local health unit for f/u after our exam. We are currently working on setting up the f/u exam for the SANE's to perform but so far it isn't ready. To few SANE's ready to perform exams.


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