Needlestick injury
A needlestick injury is a percutaneous piercing wound typically set by a needle point, but possibly also by other sharp instruments or object, Such injuries are an occupational hazard in the medical community.
Event
Needlestick injuries are a common event in the healthcare environment. When drawing blood, administering an intramuscular or intravenous drug, or performing other procedures involving sharps, the needle can slip and injure the healthcare worker. This sets the stage to transmit viruses from the source person to the recipient.
Frequency
The frequency of such events has been estimated to be about 800,000 cases in the USA alone (1999 report). Another investigation estimates the rates of injuries on a global level to affect about 3.5 million individuals. Among healthcare workers nurses and physicians appear especially at risk.
Risk
Hepatitis B carries the greatest risk of transmission, with 37 to 62% of exposed workers.
The overall risk of HIV infection after percutaneous exposure to HIV-infected material in the health care setting is 0.3%.
The specific risk of a single injury depends on a number of factors when the patients harbor the virus of concern. Injuries with a hollow-bore needle, deep penetration, visible blood on the needle, a needle that was located in a deep artery or vein, or with blood from terminally ill patients are known to increase the risk for HIV infection.
Estimates of the risk of a single injury indicate a risk of 300 HBV infections (30% risk), 30 HCV infection (3% risk) and 3 HIV infections (0.3% risk) per 1,000 respective exposures.
Prevention
Include
1. Reduction or elimination of use of sharps as much as possible, (i.e., needles or syringes).
2. Engineering controls (i.e., safety devices).
3. Administrative controls including training and provision of adequate resources.
4. Work practice controls; the latter may include using instruments (not fingers) to grasp needles, load scalpels.
5. Discarded sharps enter the medical waste stream.
Management
After a needlestick injury, certain procedures must be followed to minimize the risk of infection for the recipient:
1. The affected area should be rinsed and washed thoroughly with soap and water.
2. The practice to "milk out" more blood is controversial and not recommended by the CDC.
3. Encourage bleeding.
4. Lab tests of the recipient and for immunized individuals HB surface antibody.
5. The infectious status of the source needs to be determined by checking for HBsAG, anti-HCV, and HIV antibody, ideally within one hour of the injury.
The most serious diseases Transmitted by Needlestick:
1. Hepatitis B
2. Hepatitis C
3. HIV
A needlestick injury is a percutaneous piercing wound typically set by a needle point, but possibly also by other sharp instruments or object, Such injuries are an occupational hazard in the medical community.
Event
Needlestick injuries are a common event in the healthcare environment. When drawing blood, administering an intramuscular or intravenous drug, or performing other procedures involving sharps, the needle can slip and injure the healthcare worker. This sets the stage to transmit viruses from the source person to the recipient.
Frequency
The frequency of such events has been estimated to be about 800,000 cases in the USA alone (1999 report). Another investigation estimates the rates of injuries on a global level to affect about 3.5 million individuals. Among healthcare workers nurses and physicians appear especially at risk.
Risk
Hepatitis B carries the greatest risk of transmission, with 37 to 62% of exposed workers.
The overall risk of HIV infection after percutaneous exposure to HIV-infected material in the health care setting is 0.3%.
The specific risk of a single injury depends on a number of factors when the patients harbor the virus of concern. Injuries with a hollow-bore needle, deep penetration, visible blood on the needle, a needle that was located in a deep artery or vein, or with blood from terminally ill patients are known to increase the risk for HIV infection.
Estimates of the risk of a single injury indicate a risk of 300 HBV infections (30% risk), 30 HCV infection (3% risk) and 3 HIV infections (0.3% risk) per 1,000 respective exposures.
Prevention
Include
1. Reduction or elimination of use of sharps as much as possible, (i.e., needles or syringes).
2. Engineering controls (i.e., safety devices).
3. Administrative controls including training and provision of adequate resources.
4. Work practice controls; the latter may include using instruments (not fingers) to grasp needles, load scalpels.
5. Discarded sharps enter the medical waste stream.
Management
After a needlestick injury, certain procedures must be followed to minimize the risk of infection for the recipient:
1. The affected area should be rinsed and washed thoroughly with soap and water.
2. The practice to "milk out" more blood is controversial and not recommended by the CDC.
3. Encourage bleeding.
4. Lab tests of the recipient and for immunized individuals HB surface antibody.
5. The infectious status of the source needs to be determined by checking for HBsAG, anti-HCV, and HIV antibody, ideally within one hour of the injury.
The most serious diseases Transmitted by Needlestick:
1. Hepatitis B
2. Hepatitis C
3. HIV