Infectious Disease Book

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HIV Risk Assessment Stratification Protocol

Aka: HIV Risk Assessment Stratification Protocol, RASP Score
  1. See Also
    1. Needlestick Injury
    2. HIV Exposure
  2. Indications
    1. Quantify HIV risk associated with Needle Stick in healthcare providers
  3. Precautions
    1. Non-validated and initially created in 2003
    2. Does not include viral load data in decision making
      1. Undetectable viral load virtually eliminates risk from Needlestick Injury
  4. Criteria: Source Population (A)
    1. Score +1: Known HIV positive AND Acute AIDS Illness
    2. Score +10: Known HIV positive AND Asymptomatic HIV
    3. Score +100: Unknown HIV status AND high-risk situation
    4. Score +1000: Unknown HIV status AND low-risk situation
  5. Criteria: Inoculum Type (B)
    1. Score +1: Fresh Blood
    2. Score +10: Other high risk fluid (e.g. semen)
    3. Score +100: Dried old blood
    4. Score +1000: Low risk secretions (e.g. tears, urine, Saliva)
  6. Criteria: Method of Transmission (C)
    1. Score +1: Intravenous
    2. Score +10: Deep intramuscular
    3. Score +100: Deep transcutaneous with visible bleeding
    4. Score +200: Superficial transcutaneous without bleeding
    5. Score +500: Mucosal contact only
    6. Score +1000: Intact skin
  7. Criteria: Volume of Inoculum (D)
    1. Score +100: Massive (e.g. transfusion)
    2. Score +10: Measurable (>1ml)
    3. Score +5: Moderate (large bore hollow needle >22 gauge)
    4. Score +3: Small (Small bore hollow needle <22 gauge)
    5. Score +1: Trace surface only (e.g. Suture Needle)
  8. Interpretation
    1. Total Score (Z) = A * B * C
    2. Basic Risk = 1/Z
    3. Total Risk = Basic Risk * D
  9. References
    1. Swaminathan and Habboushe in Herbert (2019) EM:Rap 19(9): 12-3
    2. Vertesi (2003) CJEM 5(1):46-8 [PubMed]

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