Needlestick Injuries

PROTOCOL TO BE FOLLOWED AFTER A NEEDLESTICK INJURY OR BLOOD/BODY FLUID EXPOSURE.

1.   FIRST AID

o         Contaminated Wound - Encourage bleeding from the skin wound and wash the injured area with copious soapy water, disinfectant, scrub solution or water.

o         Contaminated Intact Skin - Wash the area with soap and water.

o         Contaminated Eyes -   Gently rinse the eyes while open with Saline or water.

o         Contaminated Mouth -  Spit out any fluid - rinse the mouth with water and spit out again.

2.   REPORT ACCIDENT

3.   BLOOD TESTING (Consent required)

Health Care Worker: HIV, Hep B and Hep C status

Source:   HIV, Hep B and Hep C status

4.   IMMEDIATE ACTION

If the patient is known to be HIV positive then the exposed Health Care Worker should be given counselling and offered Post exposure prophylaxis (PEP). 

The Austin Hospital, Alfred and Royal Melbourne Hospital, have Infectious Diseases Physicians on call who can discuss the case and recommend the best treatment in line with the CDC guidelines. 

Phone Nos (Austin) (9496 5000); (Alfred) (9276 2000) and (RMH) (9342 7000).

Post Exposure Prophylaxis (PEP) pdf information sheet

• PEP is the administration of 2 or 3 antiretroviral HIV medications for 28 days, commenced within 72 hours of possible exposure to HIV infection.
• PEP has been shown to reduce the risk of HIV infection following needlestick injuries to healthcare workers by 81%.
• To be at risk of HIV you need to have had risky contact (eg penetrative sex, sharing a syringe) with a person who has HIV.

5.   FURTHER ACTION

1.   If status of Patient and Health Care Worker is unknown and immune status can’t be obtained within  48 hours then give:-

(a) Hepatitis B. Immune Globulin

(b) Hepatitis B. Vaccine (first dose).

2. If the Health Care Worker is HBV immune then no further Hep B Vaccine is required. Check Hep B antibody titre of health care worker and if low give Hepatitis B booster.

3.   Give Tetanus Toxoid booster if indicated.

6.   FOLLOW UP

i.     complete the course of Hepatitis Vaccine.

ii.    follow up HIV serology 1, 3 months  and 6 months.

Reference:   Kerang and District Hospital, Infection Control Manual and other.

.