II. Background
- Needlestick related transmission risks (if source positive)
- Hepatitis B: 6% (up to 25-30% if HBeAg positive)
- Hepatitis C: 1.8% on average (up to 7% in some studies)
- HIV: 0.3% (up to 0.5% in some studies)
III. Step 1: Initial Management
- Wash wounds with copious soap and water
- Flush exposed mucous membranes with water
IV. Step 2: Evaluate Source of Exposure
- Avoid testing discarded needles or syringes
- Test known source
- Hepatitis B Surface Antigen
- Hepatitis C Virus Antibody
- HIV Test
- Rapid HIV Testing is available at many centers
- Some centers will also test p24 Antigen (identifies early HIV Infection)
- Liver Function Tests
- Assess risk of exposure if source unknown
- Hepatitis B Risk
V. Step 3: Evaluate Exposed Patient
- Assess Hepatitis B Immune Status
- Prior Vaccination
- Vaccine response
- Initial labs
- Follow-up labs
- Anti-HCV RNA
- Consider testing at 2, 4 and 8 weeks after exposure
- Repeat at 4-6 months after exposure
- HIV Test
- Repeat at 6 months after exposure
- Anti-HCV RNA
VI. Step 4: Management of the exposed patient
- Postexposure Prophylaxis
- Prevent transmission of possible infections
- Use protection from Sexually Transmitted Disease
- Consider Immunization of close contacts
VII. Prevention: Pre-exposure
- Healthcare workers should be immunized with Hepatitis B Vaccine
- Use retractable syringe needles and have readily available sharps containers
- Avoid re-capping needles
VIII. References
- Orman and Moran in Herbert (2016) EM:Rap 16(4):16-7
- Moran (2000) Ann Emerg Med 35(1):47-62 [PubMed]
- (2001) Am Fam Physician 64(12):2012-14 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| Definition (MSH) | Penetrating stab wounds caused by needles. They are of special concern to health care workers since such injuries put them at risk for developing infectious disease. |
| Concepts | Injury or Poisoning (T037) |
| MSH | D016602 |
| SnomedCT | 283596007 |
| LNC | LA7323-4 |
| English | Injuries, Needle-Stick, Injuries, Needlestick, Injury, Needle-Stick, Injury, Needlestick, Needle Stick Injuries, Needle Sticks, Needle-Stick, Needle-Stick Injuries, Needle-Stick Injury, Needle-Sticks, Needlestick, Needlestick Injuries, Needlestick Injury, Needlesticks, NEEDLESTICK INJ, INJ NEEDLESTICK, Needlestick Injuries [Disease/Finding], needle stick injuries, needle-stick, needlestick injury, needle stick, needlestick injuries, Injury;needle stick, needle sticks, needle-stick injuries, needle-stick injury, needlestick, needlesticks, Needlestick injuries, Needle stick, Needle prick injury, Needle stick injury, Needle stick injury (disorder), needle stick injury |
| French | Blessures par piqûre d'aiguille, Lésions post-traumatiques accidentelles dues à une piqûre d'aiguille, Piqûres d'aiguille, Traumatismes accidentels dus à une piqûre d'aiguille, Plaies par instrument piquant |
| Swedish | Nålsticksskador |
| Czech | poranění bodné jehlou, zranění injekční stříkačkou |
| Finnish | Neulanpistovammat |
| Russian | RANY PRONIKAIUSHCHIE, IGLOI, TRAVMY MEDRABOTNIKOV OT IN"EKTSIONNOI IGLY, РАНЫ ПРОНИКАЮЩИЕ, ИГЛОЙ, ТРАВМЫ МЕДРАБОТНИКОВ ОТ ИНЪЕКЦИОННОЙ ИГЛЫ |
| Polish | Przypadkowe zranienie igłą, Zakłucie się igłą, Zranienia igłą |
| Japanese | 注射針刺傷(チュウシャシンシショウ), 注射針刺傷 |
| Norwegian | Nålestikkskader, Sprøytestikkskader, Nålestikk |
| Portuguese | Traumatismos Penetrantes Produzidos por Agulha, Ferimentos Penetrantes Produzidos por Agulha |
| Spanish | lesión por pinchazo con aguja (trastorno), lesión por pinchazo con aguja, Lesiones por Pinchazo de Aguja |
| German | Injektionsnadelverletzungen, Stichverletzungen, Injektionsnadel-, Verletzungen, Injektionsnadel- |
| Italian | Ferite da aghi |
| Dutch | Accident, prik-, Accidenten, prik-, Prikaccident, Prikaccidenten |
Ontology: Blood borne transmission (C1636665)
| Definition (HL7V3.0) | <p>Communication of an agent to a living subject through direct contact with blood or blood products whether the contact with blood is part of a therapeutic procedure or not.</p> |
| Concepts | Functional Concept (T169) |
| SnomedCT | 420014008 |
| HL7 | BLDTRNS |
| Spanish | transmisión sanguínea (calificador), transmisión sanguínea |
| English | blood borne transmission, Blood borne transmission (qualifier value), Blood borne transmission, Bloodborne transmission |
