Needle Stick Injuries

John
Needle Stick Injury
 800,000 Needlestick Injuries
Occur Each Year in the United
States
 Needlestick Injuries Among
Health Care Workers

Source: EPINet data, University of Virginia

Source: EPINet data, University of
Virginia
Needlestick Injuries Are Underreported by
Health Care Workers

Reasons
Lack of time
Employer response
Concern about HIV status
 What Types of Devices Are Most Commonly
Involved in Needlestick Injuries?
Hollow-bore needles are the cause of injury in
68.5% of cases
Items Most Frequently Causing Sharp-
Object Injuries, 1995
Location Where Puncture Injuries and Other
Blood Exposures Occurred, 1995
The majority of needlesticks occur when health care
workers:

Dispose of needles
Administer injections
Draw blood
Recap needles
Handle garbage and dirty linen
When Do Needlesticks Happen?
HBV and HCV Pose an Even Greater Risk Then HIV
 Occupational Risk of
Hepatitis C:

HCV - major cause of chronic liver disease

No vaccine
No effective post-exposure prophylaxis
85% of HCV infected people develop chronic
infection
 Occupational Risk of
Hepatitis B:
Much more transmissible than HIV
Risk after needlestick: 2% - 40%
1994 (USA) - 1000 health care workers
developed HBV infection
Approximately 200 Health Care Workers
die each year in USA
Estimated Incidence of Acute Hepatitis B
United States, 1978-1995
Occupational Risk of HIV:

Risk after needlestick - 1 in 300

Exposures from needlesticks or cuts

cause most infections
 Personal Protective Equipment alone
Usually Does Not
Adequately Protect the Health Care Worker from
Needlesticks

Gloves provide a barrier,

but…
Most personal protective equipment is
easily penetrated by needles
Immediate Management of Sharp Injuries
or Exposure to Blood and Body Fluid
In case if injury with a used needle or other
sharp or if bloody/body fluid is splashed
into mouth, eyes or onto broken skin, carry
out the following procedures:
1. Needle pricks, cuts, bites or scratches
a. Encourage bleeding by squeezing
b. Wash thoroughly with soap and water
c. Cover with waterproof dressing
2. Splashes to mouth or eyes.
Rinse thoroughly with plenty or running
water. NEVER use soap. Why?
3. Inform your manager immediately.
4. Complete the accident/incident form.
If known, include the name of the patient
from whom the sharp/body fluid came.
5. Report to the accident and emergency
department for further advice if working
in a hospital.
Immediately after the accident exposure, the injury
should evaluated for risk of infection according to:

Severity of the exposure.

Depth of injury.
Duration of exposure.
Type of instrument/needle involved (hollow bore
or suture needle).
Serological status of the patient.
Stage of disease of the source patient.
Dispose of
Sharps
properly
 Good Practices for the Safe
Handling and Disposal of Sharps

ALWAYS dispose of your own sharps. NEVER

pass used sharps directly from one person to
another; this practice should be followed by ALL
health care workers;
During exposure-prone procedure, the risk of
injury should be minimized by ensuring that the
operator has the best possible visibility, e.g. By
positioning the patient, using as good a light
source as possible and controlling bleeding.
Dispose of, and transport sharps in a puncture-
resistant container.

NEVER place used sharps in other waste

containers;

Keep all sharps and sharps disposal containers

out of the reach of children;

•Prevent overflow by sending sharps disposable

containers for incineration when three-quarter
full.
 Bleach is used to wipe benches,
and cleaning blood spills.
Never use bleach to clean chairs where the patient
sits. Why?
Although it is widespread, NEVER put bleach in
spray bottles. Why?
Eye wash bottles should be out of the box with the
seal removed and placed in an easy to get place.