Preliminary Positive Flow Sheet For

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					                             Preliminary Positive Flow Sheet

24/7 IL Perinatal HIV Hotline 1- 800-439-4079
            Inform delivering physician, pediatrician and nurse in charge.

          Order STAT AZT (goal is started < 30 minutes from result)
           ~Mom in labor: 2mg/kg load x 1 hour, then 1mg/kg/hr until delivery
           ~Newborn: 4mg/kg PO syrup Q 12 hours or 2mg/kg PO syrup Q 6 hours
               <36 weeks: Call Perinatal HIV Hotline 1-800-439-4079

         Locate Preliminary Positive Packet in Rapid Testing Binder
         protocols, release of information and preliminary positive form.

          Inform patient of preliminary result and the need to start AZT as soon as possible
         ~preliminary positive result
         ~importance of starting medicine immediately to prevent transmission to baby
         ~need to confirm result with a test that takes a few days
         ~no breastfeeding (pump and dump until status confirmed)

                           Send confirmatory Western Blot test

         Follow guidelines for Labor and Post-Delivery Care for HIV+ Women and
         Exposed Newborns.
          ~Expedite Labor if Rupture of membranes has occurred
          ~No invasive procedures in labor
          ~Early bath for infant in DR/cleanse skin before any injection
          ~Start AZT syrup for newborn ASAP after delivery

         Call IL Perinatal HIV Hotline for clinical information, referral and follow-up
         assistance 24/7 Illinois Perinatal HIV Hotline 1- 800-439-4079

         Counsel patient to sign Release of Information Form for case management and

         Fill out Preliminary Positive Data Collection Form
          ~if patient signed Release of Information, fill in patient identifiers and fax
         both forms to PACPI (PACPI): Fax (312) 334-0973, Attn: Anne Statton.
         For questions, call (312) 334-0974 or email

         ~Mom Discharged with >7 day supply of AZT syrup for newborn and home
          VNA support
         ~Consult: Infectious Disease, Social Work
         ~Arrange referral for Specialized HIV care for mom/baby. Confirm link to care.
         ~Set plan for informing patient of confirmatory Western Blot results

**** It is the attending physician’s responsibility to ensure patient is informed of confirmatory test
results, link to care takes place and infant has appropriate AZT. Local Dept. of Public Health/PACPI
can be called to assist with follow-up****
                                                                                               Revised 11/2010

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