Red flags & when to go in person for Post-Exposure Prophylaxis (PEP) Evaluation

Audience: pediatric

Post-Exposure Prophylaxis (PEP) is a treatment given after possible exposure to certain infections, such as HIV, to reduce the chance of becoming infected. For children, timely evaluation is important because PEP works best when started as soon as possible, usually within 72 hours after exposure. Telemedicine can help assess the situation quickly and guide families on next steps. However, some signs and circumstances require an in-person visit to ensure safety and proper care. This guide helps parents and caregivers recognize when to seek immediate medical attention and what to expect during telemedicine visits for PEP evaluation. Remember, this information is educational and not a substitute for professional medical advice or emergency care.

Red flags — go in person / ER

• Child has trouble breathing, persistent chest pain, or severe headache after exposure — seek emergency care immediately.
• Signs of allergic reaction such as swelling of the face or throat, rash, or difficulty swallowing — go to emergency services right away.
• Exposure involves deep wounds, animal bites, or contact with blood from a person known to have an infection — urgent in-person evaluation is needed.

What telemedicine can do

• Initial risk assessment for possible exposure to HIV or other bloodborne infections.
• Providing education about PEP timing, use, and side effects.
• Guidance on whether PEP is appropriate and how to obtain medication.
• Follow-up advice and symptom monitoring after starting PEP.

What telemedicine cannot do

• Emergency situations such as breathing difficulty, severe allergic reactions, or severe injuries.
• Physical examination of wounds requiring cleaning, suturing, or rabies vaccination.
• Laboratory testing that requires blood draws or other samples.
• Management of side effects requiring immediate medical intervention.

What is Post-Exposure Prophylaxis (PEP)?

PEP is a short course of medicine taken after possible exposure to infections like HIV. It aims to prevent infection if started quickly, often within 72 hours. PEP is usually given for about 28 days and requires medical evaluation to decide if it is needed.

When to Use Telemedicine for PEP Evaluation

Telemedicine can help families quickly talk to a healthcare provider about possible exposure. It allows for fast assessment of risk factors and guidance on whether PEP might be needed. This can be especially helpful when in-person visits are difficult or delayed.

Red Flags That Need In-Person Care

Certain signs mean your child needs to be seen in person right away:

If any of these occur, seek emergency care immediately.

Preparing for a Telemedicine Visit

Before your tele-visit, gather information such as:

Having this ready helps the provider give the best advice quickly.

What Happens After a Telemedicine Evaluation

The healthcare provider may:

Follow their instructions carefully to ensure the best outcome.

How to prepare for your tele-visit

• Note the exact time and nature of the exposure event.
• Gather information about the source of exposure, if known (e.g., HIV status).
• Prepare a list of your child's current medications and allergies.
• Have a device ready with a stable internet or phone connection for the telemedicine visit.
• Be ready to describe any symptoms your child is experiencing.
• Have contact details of your child's primary healthcare provider available.

After your tele-visit

• Follow the healthcare provider's instructions on starting PEP medication promptly, if recommended.
• Schedule any recommended follow-up appointments or lab tests.
• Monitor your child for side effects or new symptoms and report them promptly.
• Maintain open communication with healthcare providers during the treatment period.
• Seek immediate in-person care if red flags or emergency symptoms develop.

FAQs

How soon should PEP be started after exposure?

PEP should ideally be started within 72 hours (3 days) after possible exposure to be most effective. The sooner it is started, the better the chance of preventing infection.

Can PEP be given to children safely?

Yes, PEP can be given to children, but the medication and dosage may differ from adults. A healthcare provider will determine the safest and most effective treatment based on the child's age and weight.

What if I’m not sure if my child was exposed?

If you are uncertain about the exposure risk, a telemedicine visit can help assess the situation. The provider can guide you on whether PEP evaluation is needed and what steps to take next.

Are there side effects of PEP I should watch for?

Some children may experience side effects like nausea, fatigue, or headaches. Most side effects are mild and temporary, but if your child has severe symptoms or allergic reactions, seek medical care immediately.

Is follow-up testing needed after PEP?

Yes, follow-up testing is typically recommended to ensure the child remains infection-free. The provider will advise on the timing and type of tests needed after completing PEP.

Sources

1. Post-Exposure Prophylaxis (PEP) — Centers for Disease Control and Prevention (CDC).
2. HIV Post-Exposure Prophylaxis (PEP) — MedlinePlus, U.S. National Library of Medicine.
3. Post-Exposure Prophylaxis (PEP) for HIV — National Institute of Allergy and Infectious Diseases (NIAID).
4. Post-Exposure Prophylaxis (PEP) in Children — American Academy of Pediatrics (AAP).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical evaluation, diagnosis, or treatment. If your child has emergency symptoms or you are concerned about their health, seek immediate medical care.