Show As you work, you may experience:
If any of these occur, take the following steps:
Medical Providers Please NoteIf you have questions about proper medical treatment for workplace exposures: Recommendations for the management of occupational exposures to blood: Updated U.S. Public Health Service Guidelines Management Occupational Exposures HIV Recommendations PEPexternal icon Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis CDC Guidance for Evaluating Health-Care Personnel for Hepatitis B Virus Protection and for Administering Postexposure Management Postexposure Prophylaxis to Prevent Hepatitis B Virus Infection Infographic: Exposed to HIV? The clock is ticking! Take Action!pdf icon Although healthcare workers are those most often affected by needlestick injuries, other occupations can be affected - eg, refuse collectors, cleaners and tattoo artists. Needlestick injuries may also affect carers and children picking up used needles. Any infectious agent can theoretically be transmitted by needlestick injury but in reality the major blood-borne pathogens of concern y are hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV. The average estimated seroconversion risks from published studies and reports are[1] :
A Health Protection Agency (HPA) report regarding healthcare workers, released in 2012, stated that[2] :
Certain features of a percutaneous needlestick injury carry a particularly high risk[3] :
In one study of 98 UK surgeons in a large district general hospital, 44% anonymously admitted to having a needlestick injury. The study concluded that the incidence of such injuries was likely to be under-reported, particularly in the surgical sector[4] . Follow local or national or international protocol[5, 6, 7, 8] . The study of surgeons in a district general hospital found that only 3% followed agreed local policy, and promotion of the importance of safety procedures needed to be emphasised[4] . First aid
Report the needlestick injury and discuss with a local public health consultant immediatelyDiscuss type of needlestick injury, donor HIV status if known, etc. In the case of definite exposures to blood or other high-risk body fluids known or considered to be at high risk of HIV infection, post-exposure prophylaxis (PEP) should be offered as soon as possible, preferably within one hour of the needlestick injury. It may still be worth considering up to 72 hours after the exposure, but the relative benefit of prophylaxis diminishes with time. PEP is not recommended if the index case is known to have a low viral load. The current standard recommended regimen for PEP is a 28-day course of[1] :
See also the separate HIV Post-exposure Prophylaxis article. For hepatitis B vaccine and immunoglobulin see the separate Hepatitis B Vaccination and Prevention article. The exposed person should also be advised:
Fill out the accident book and the complete critical event audit. Consider carefully how subsequent events can be prevented. Follow-upEnsure there is adequate follow-up of both care worker and donor. The care worker in particular will require early involvement by the occupational health service. They may need specific advice on having to take sick leave if medication is required and the possible requirement for psychological support. This is of prime importance. The HPA (now part of Public Health England) advises the following[6] :
This will obviously depend on the procedure being undertaken but may include:
More advice is available in the 2013 Sharp Instruments in Healthcare Regulations[11] . Guidance for NHS employers (who are now under a statutory obligation to prevent and control spread of healthcare-associated infection) can be found on the NHS Employers' website[1] . |