Postexpositionsprophylaxe

Postexpositionsprophylaxe, usually shortened to PEP, is the medical response that follows a possible contact with foreign blood or another potentially infectious material. It is prophylaxis rather than treatment, because it is considered before anyone knows whether a transmission has taken place. In a pharmacy that draws blood the trigger is almost always a Nadelstichverletzung, a cut from a broken sample tube, or blood reaching an eye, the mouth or skin that is not intact.

The defining feature of PEP is the time available. The window in which prophylaxis can still influence an outcome is counted in hours rather than days, and for some exposures the earliest hours matter most. Waiting until the next morning, or until the shop closes, or until the injured person has finished the shift, can remove the option altogether. That is why the sequence is settled in advance rather than discussed while someone stands at the sink with a bleeding finger.

The decision itself does not belong to the pharmacy. Assessing the exposure, judging the source and deciding whether any prophylaxis is indicated is a physician's task, normally the Durchgangsarzt named for the pharmacy or, outside opening hours, the hospital covering the district. That holds even though the team is pharmaceutically trained and even though the relevant products may be a few metres away on a shelf. Reasoning towards a recommendation, or naming an agent to a colleague in that moment, is outside the pharmacy's role and adds nothing the physician needs.

What the pharmacy contributes is speed, information and documentation:

1. Speed means the injured person leaves for the named address at once, accompanied if necessary, rather than once the queue has cleared.
2. Information means the physician receives every fact that decides the assessment.
3. Documentation means the Verbandbuch entry and the Arbeitsunfall report are made the same day, because an event written up weeks later is hard to attribute.

The facts the physician needs about the exposure are these:

• Say which device was involved and what was being done with it.
• Say how deep the injury went and whether the cannula had been in a vessel.
• Give the exact time at which the exposure happened.
• Give the vaccination status of the injured person as well.

Knowing the route in advance is the part fully within a pharmacy's control. The name, address and out of hours contact of the Durchgangsarzt belong on the wall beside the station rather than inside a folder, and the route is discussed on a quiet morning rather than during an emergency.

The duty to organise this belongs to the employer under the Biostoffverordnung, and TRBA 250 describes it next to the equipment and instruction requirements. The daily routine set out under Hygiene bei der Blutentnahme is what keeps the question hypothetical, which remains the cheapest outcome by a wide margin.