Staff Exposure

Commonly referred to as a needlestick injury.

Blood and body fluid exposure occurs when a healthcare staff member is exposed to patient fluid that could contain a potentially transmissible organism.

Indications

Contraindications

Principles

Management

Management:

  1. Staff member to abort procedure/scrub out
  2. Clean site
    • Wound
      • Irrigate under running water for several minutes
      • Wash with soap and water
      • Apply aqueous betadine
    • Eyes
      • Remove contact lenses
      • Rinse with saline or water
    • Clothing
      • Remove
      • Shower if necessary
  3. Report incident
    Risk management process.
  4. Conduct risk assessment
    • Patient factors
      • Known blood-borne disease
      • High blood titre of blood-borne disease
      • Risk factors for blood-borne disease
    • Event factors
      • Hollow needle
      • Large needle
      • Intravascular needle
      • Gloves
        • None
        • Double
      • Depth of wound
      • Wound into vein or artery
      • High volume exposure
  5. Perform investigations
    • Staff
      For immunity.
    • Patient
      For HIV, HBV, HCV.
  6. Management
    • Consider need for post-exposure prophylaxis
      • Discuss with ID
      • Arrange counselling
      • Patient and staff followup
    • Post-exposure prophylaxis
      • Hepatitis B
        IVIG.
      • HIV
        Antiretrovirals, must be commenced within 2 hours.
    • Barrier protection with intercourse for 6 months
    • No blood donation
    • Emotional support
    • Review procedural technique

Policy for third-party consent or medical consent for testing patients without capacity is present in many institutions.

Complications

Key Studies

References