Blood-borne viruses and performing exposure-prone procedures

The responsibility of registrants

Blood-borne viruses (BBVs) refers specifically to the following:

  • hepatitis B virus (HBV)
  • hepatitis C virus (HCV)
  • human immunodeficiency virus (HIV)

The College’s expectations

The College’s Blood-borne Viruses in Registrants practice standard outlines registrants’ responsibilities to safeguard the health of both patients and other health-care workers.

Registrants must minimize the risk of transmitting blood-borne viruses during the provision of medical care. It applies to all registrants who perform or assist in performing exposure-prone procedures (EPPs).

The College expects all registrants to:

  • maintain their own wellness
  • know their own serological and infectious status
  • be appropriately immunized
  • receive treatment
  • only perform or assist in performing EPPs when their health and viral loads make it safe
  • follow relevant post-exposure protocols of the BC Centre for Disease Control

SHEA guideline

The Society for Healthcare Epidemiology of America (SHEA) guideline, Table 2, Category III outlines exposure-prone procedures, which include:

  • intrapartum obstetrics
  • emergency department procedures such as open resuscitation efforts, deep suturing to arrest hemorrhage, and internal cardiac massage
  • surgeries (including by surgical assistants)
    • general
    • oral
    • cardiothoracic
    • extensive head and neck surgery
    • neurosurgery
    • obstetrical/gynecological (including vaginal/cervical repair)
    • orthopedic
    • extensive plastic surgery
    • transplantation surgery (except skin and corneal transplantation)
    • trauma surgery
  • any open surgical procedure with a duration of more than three hours, probably necessitating glove change

Health monitoring of registrants infected with a BBV

Registrants infected with BBV will be able to continue to perform or assist in performing EPPs if the College determines it will not compromise patient safety. In making this determination, the College will be informed by the Blood Borne Communicable Diseases Committee. The health information reviewed by the committee is an anonymous process and protects the privacy of the registrant.

Registrants infected with a BBV who wish to perform or assist in performing EPPs must consent to health monitoring by the College. This will include their consent to being under the care of an approved treating physician, including monitoring of their viral loads, as recommended by their treating physician and the committee.