Inadvertent sharps injury and occupational exposure to blood or bodily fluids is relatively common and may cause significant distress to the person exposed.
All workplaces have protocols in place for the management of occupational exposures which should be strictly followed.
Junior doctors should be familiar with the immediate management of needlestick injury and other exposures, know how to report them, and where to access support and advice.
- Remove the hazard and place into sharps bin
- Thoroughly wash the area with running water and soap
- Apply a sterile dressing if needed
- Apply pressure for haemostasis as needed
- Do not rub or attempt to express blood from the site
- Thoroughly wash the area with copious amounts of clean water +/- soap
- If the eyes are affected:
- Ensure any contact lenses are removed
- Use of an eye washer is ideal, if unavailable use sterile saline
- If there is a splash to the mouth expectorate several times and rinse with water multiple times
- Remove and contaminated clothing as shower if needed (1)
- All sharps and bodily fluid exposures should be immediately reported to your supervisor, the OH&S officer and the infection prevention team or your hospital’s equivalent.
- An incident report should be lodged detailing:
- The sight of exposure (eg. finger, eye, broken skin, mouth etc)
- Type of fluid (eg. blood, saliva, urine, vaginal fluids, pleural fluid etc)
- Estimate of the volume of fluid (eg. was the patient’s blood injected into the worker)
- The time and the procedure being undertaken when the incident occurred
- Any precipitating events (eg, occurredwhilst re-capping a needle etc)
- The patient (source) should be informed about the incident and their consent should be sought to be tested for blood borne viruses (hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and human T-cell lymphotropic virus type I (HTLV-I).
- This can help stratify the risk to the person exposed and guide decisions about post-exposure prophylaxis.
- A negative result from the source does not equate to zero risk of transmission as there is a lag-time between contracting a virus and returning a positive test of up to 3 months.
- The exposed person should be tested for the same blood borne virus as above and also a baseline HBV surface antibody level
- A risk-assessment and decision about post-exposure prophylaxis will be made in consultation with the infectious disease physician at your hospital
- You will be provided with counselling about your individual risk and what to expect for the next 6 months in regard to testing, workplace adjustments, household, and sexual contacts. (2)