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NEEDLESTICK/SHARPS INJURY

A skin puncture caused by a hypodermic needle or sharp or broken item of equipment (e.g. scalpel, mounted needle, broken glassware, etc.) A needlestick injury is of concern because of the risk of transmission of blood-borne viruses (HBV, HCV, HIV). Most common cause in healthcare professionals is attempted re-sheathing of needles.

Health & Safety Executive Sharps injuries, 2013 https://www.hse.gov.uk/healthservices/needlesticks/

Public Health England. Eye of the Needle, 2014. 

 

If the sharp was used or dirty:

  • Encourage wound to bleed, to expel contaminants
  • Wash with soap and warm water. Do not scrub. Do not use antiseptics
  • Dry and apply waterproof plaster
  • Report to practice manager/senior partner immediately
  • Assess risk - contact occupational health or local consultant in communicable disease control/consultant microbiologist/virologist or genitourinary medicine or A&E
  • Complete accident form.

See Green Book for prophylaxis and procedure where there is substantial risk of blood-borne infection (HIV or hepatitis), also for primary and reinforcing immunisation.

Hepatitis B prophylaxis

HBV immunoglobulin (HBIG) confers passive immunity and gives immediate but temporary protection after accidental inoculation or contamination with HBV-infected blood. HBIG is recommended only in high-risk situation or a known non-responder to vaccine. Should ideally be given with 24 hours of exposure, but can be considered at up to 1 week. An HBV vaccination course confers active immunity. If an unprotected individual is at high risk of infection, the vaccine can be given at the same time as HBIG.

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