Download ArticleDownload ArticleThis article was co-authored by David Nazarian, MD. Dr. David Nazarian is a board certified Internal Medicine Physician and the Owner of My Concierge MD, a medical practice in Beverly Hills California, specializing in concierge medicine, executive health and integrative medicine. Dr. Nazarian specializes in comprehensive physical examinations, IV Vitamin therapies, hormone replacement therapy, weight loss, platelet rich plasma therapies. He has over 16 years of medical training and facilitation and is a Diplomate of the American Board of Internal Medicine. He completed his B.S. in Psychology and Biology from the University of California, Los Angeles, his M.D. from the Sackler School of Medicine, and a residency at Huntington Memorial Hospital, an affiliate of the University of Southern California.
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Medical workers are at risk for getting injured by needles and other devices used to puncture or lacerate the skin (sharps). Indeed, it is estimated that in excess of 600,000 needle stick injuries occur to US health care workers every year, each a potential exposure to disease, diseases such as hepatitis B, hepatitis C and HIV. A needle stick (or sharps) injury can happen easily and infection can follow, so it is vital to take immediate precautions so that infection does not result.[1] See Step 1 to find out what to do.
Steps
Encourage bleeding at the site of puncture. Do this by running cool water over the bleeding area for several minutes.[2] In this way potential infectants are expelled from the wound and washed away, minimizing entry into the bloodstream. Once the virus enters your bloodstream, it may start to multiply, so it is best to keep the virus cells from entering the bloodstream in the first place.- Don't squeeze the wound.
Wash the wound. Gently cleanse the site of the needle stick or sharps entry with plenty of soap after you have bled the wound and flooded the site. This will help to kill viruses and bacteria, removing sources of infection and reducing the chance of infection.[3]- Do not scrub the wound while you're washing it. This can make the injury worse.
- Never try to suck the wound.
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Dry and cover the wound. Use a sterile material to dry the wound and immediately cover the wound with a waterproof plaster or dressing.[4]
Flush splashes of blood and needle contents on other parts of your body with water. If the contents of the needle splashed to nose, mouth, face or other skin areas, wash them well with soap.[5]
Irrigate eyes with saline, clean water or sterile irrigants. Gently flush the eyes if any splashing occurred there.[6]
Remove and change potentially contaminated clothing. Place clothing in a sealed bag awaiting washing and sterilization. After undressing, wash your hands and parts of the body that were in contact with the potentially infectious clothing, then don fresh clothing.[7]
Seek medical attention immediately. You will need to explain the circumstances of the injury and discuss possible disease exposures. Your blood may be tested to determine whether further treatment is needed.[8]- In the case of known exposure to other pathogens, immediate treatment will be administered. This could involve antibiotics or a vaccination.[9]
- You might need a tetanus shot, depending on your prior history.
Determine whether HIV exposure is possible. Measures should be immediately taken to prevent sero-conversion from occurring. Scientists have proven that sero-conversion due to needle stick injuries for HIV is about 0.03 percent.[10] This percentage is extremely low, so there is no need to panic.- The HIV status of the worker affected and the person whose blood was transferred will be checked. Hospitals and other medical facilities have rapid tests available to give a confirmed HIV status.
- If exposure is likely, prophylactic medication (known as post exposure prophylaxis, or PEP) should be administered, preferably within an hour. Anti-retroviral drugs can reduce the rate of transmission if given soon after possible infection.[11] All clinics and hospitals have a protocol in place for prompt action when responding to needle stick injuries.
Determine whether other exposures are possible. The risk for hepatitis transference is much higher that that for HIV (about 30% for Hepatitis B and about 10% for Hepatitis C), so swift action is essential, as well as preventative measures (i.e., being vaccinated against Hepatitis).[12]
Report the incident. Check the reporting procedures of your workplace. It is important to let your workplace know what has happened, and the statistics so gathered can help to improve workplace practices for everyone's future safety. This includes injuries with sterile, "clean" sticks.
Have follow up testing and medical supervision of your recovery. This should be done at required intervals through the window period, the time during which a person exposed to a virus still tests negative, even though the virus is multiplying.- Retesting for HIV exposure usually occurs at six weeks, three, six, and 12 months to look for HIV antibodies.
- Retesting for HCV antibodies usually occurs six weeks after the incident, and again at four to six months.
Have a plan of action for next time. If your workplace doesn't already have a protocol in place for dealing with needlestick injuries, create one. This information is freely available on any telephonic helpline or is physically available at pharmacies, hospitals, clinics, and other medical care centers.[13]
Ensure safe working practices in a health care environment at all times. The World Health Organization recommends the following for workplaces dealing with needle sharps:[14]- Hand wash after direct contact with patients.
- Use protective barriers such as gloves, gowns, aprons, masks, and goggles when in direct contact with blood and other body fluids.
- Collect and dispose of needles and sharps safely. Use puncture- and liquid- proof boxes in each patient care area.
- Prevent two-handed recapping of needles. Use the one handed needle capping technique.
- Cover all cuts and abrasions with a waterproof dressing.
- Promptly and carefully clean up spills of blood and other body fluids with gloves on.
- Use a safe system for health care waste management and disposal.
Ensure safe working practices in other workplace environments. Tattoo parlors, piercing shops, and many other types of workplaces also put workers at risk for needlestick injuries. Take the following precautions:- Wear appropriate clothing and protective gear when handling potentially dangerous items such as garbage bags or picking up piles of garbage.
- Take care when sticking your hands into places you cannot see, such as sinks of water, holes, the backs of beds and sofas, etc.
- Wear solid footwear when walking through or working in areas known for drug-use, such as parks, beaches, public transportation hubs, etc.
Avoid unnecessary distractions when working with needles and syringes. Concentrate on your work and on what you are currently doing at all times.[15]- Avoid looking away or working in bad light while dealing with the needle stick.
- Be careful with restless or panicking patients who can easily move as you insert or withdraw the needle. Reassure them and only insert the needle when you're sure it is safe to do so.
Expert Q&A
- QuestionI pricked myself with a lancet 15 minutes after an HIV patient was pricked with the same one. What should I do?
Jonas DeMuro, MDDr. DeMuro is a board certified Pediatric Critical Care Surgeon in New York. He received his MD from Stony Brook University School of Medicine in 1996. He completed his fellowship in Surgical Critical Care at North Shore-Long Island Jewish Health System and was a previous American College of Surgeons (ACS) Fellow.
Board Certified Critical Care SurgeonThis is a needle stick injury, and this needs to be reported to your supervisor so it can be documented. After immediate handwashing, you need to report to the ER, and the decision will be made for post exposure HIV prophylaxis with medications. They will also assess the situation for hepatitis viruses.
Video
Tips
Things You'll Need
- Clean water or saline solution to irrigate wound
- Medical attention
- Schedule for treatment
Expert Interview
Thanks for reading our article! If you'd like to learn more about health treatment in the working place, check out our in-depth interview with David Nazarian, MD.
References
- ↑ https://www.ncbi.nlm.nih.gov/books/NBK493147/
- ↑ https://www.nhs.uk/common-health-questions/accidents-first-aid-and-treatments/what-should-i-do-if-i-injure-myself-with-a-used-needle/
- ↑ https://www.nhs.uk/common-health-questions/accidents-first-aid-and-treatments/what-should-i-do-if-i-injure-myself-with-a-used-needle/
- ↑ https://www.ccohs.ca/oshanswers/diseases/needlestick_injuries.html
- ↑ https://www.cdc.gov/niosh/topics/bbp/emergnedl.html
- ↑ https://www.cdc.gov/niosh/topics/bbp/emergnedl.html
- ↑ https://www.safety.uwa.edu.au/incidents-injuries-emergency/first-aid/needlestick
- ↑ https://www.patient.info/doctor/needlestick-injury
- ↑ https://www.ncbi.nlm.nih.gov/books/NBK493147/
- ↑ https://www.ccohs.ca/oshanswers/diseases/needlestick_injuries.html
- ↑ https://www.avert.org/needlestick.htm
- ↑ https://www.ccohs.ca/oshanswers/diseases/needlestick_injuries.html
- ↑ https://www.cdc.gov/niosh/docs/2012-123/pdfs/2012-123.pdf
- ↑ https://www.avert.org/needlestick.htm
- ↑ https://opentextbc.ca/clinicalskills/chapter/safe-injection-administration-and-preparing-medication-from-ampules-and-vials/
About This Article
Medical Disclaimer
The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.
While medical workers are at high risk for needle-stick injuries, there are ways to deal with them so that an infection doesn’t set in. After getting stuck by a needle, run cool water over the affected area for several minutes to encourage bleeding at the puncture site. This can keep the virus cells from entering your bloodstream. Once you flood the wound, wash it gently with plenty of soap to kill viruses and bacteria. You can then dry the wound with a sterile material and cover it with a dressing. If the contents of the needle splashed anywhere else on your body, wash it well with soap and water. When the wound is taken care of, see a doctor immediately to determine if you’ll need further treatment or tests. To learn how to avoid needlesticks, keep reading!
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