Sharps, splash, bite and needlestick injuries

A needlestick injury is an incident, which causes a used needle, blade (such as scalpel) or other medical instruments to penetrate the skin. This is sometimes called a sharps or percutaneous injury. In a “Clinical Environment” It can also refer to an “eye splash” injury, where blood or other body fluids make contact with the eye.

Accidental exposure to human blood, other body fluids or tissue could lead to contracting a blood-borne virus such HIV, hepatitis B (HBV) and hepatitis C (HCV).

The risk of infection varies according to the ‘pathogen’ involved and the circumstances of the accident.

If you do have an accident, do not assume that you are safe.

If from a patient they may be unaware that they are infected, or have not disclosed their status or have it recorded in their medical notes. An assessment by an experienced clinician will be necessary

First aid for needle stick injury

If you suffer an injury from a sharp which may be contaminated:

  1. encourage the wound to gently bleed, ideally holding it under running water
  2. wash the wound using running water and plenty of soap; leave under running water for a minimum of 10 minutes - ideally 20 minutes
  3. do not scrub the wound whilst you are washing it
  4. do not suck the wound
  5. dry the wound and cover it with a waterproof plaster or dressing

Immediate action following a potential exposure incident - in all cases

  1. encourage the wound to bleed, but do not scrub the wound - this may increase tissue damage
  2. wash any wound or contaminated skin with soap and clean water - cover with a sterile dressing
  3. if blood is splashed into the eye or mouth, stop and wash out immediately with tap water or saline

Next actions to be taken - Hospital setting

  1. report the incident to the person in charge - your supervisor, ward manager/duty doctor. Don’t delay, or fail to report the accident even if you were not following the correct procedures
  2. follow the John Radcliffe NHS Trust needle stick injury policy
  3. exposure risk assessment, including the patient and donor risk assessment
  4. you may need to go to A&E for assessment and in rare circumstances, for the PEP (post-exposure prophylaxis)
  5. you may need to visit the Occupational Health Department at the John Radcliffe Hospital for bloods and Hepatitis B Vaccinations / booster vaccine
  6. in all cases, please contact the Oxford University Occupational Health Services (OHS) on 01865 (2)82676, from 8.30am to 4.30pm Monday to Thursday, and 08.30am to 3.30pm on Fridays, as soon as possible and no later than the next working day so that any necessary follow up health assessment and support can be initiated.

Please note

Always inform the OHS of the incident as soon as possible and no later than the next working day so that any necessary follow up health assessment and support can be initiated.

 

Next actions to be taken - Laboratory setting

  1. report the incident to the senior person on duty and ensure you have all the details of the potentially infectious materials to hand
  2. contact immediately Occupational Health Services (OHS) 01865 (2)82676, from 8.30am to 4.30pm Monday to Thursday, and 08.30am to 3.30pm on Fridays
  3. if outside of OHS operating hours, telephone the on-call microbiologist or virologist via the John Radcliffe Hospital Switchboard  on 01865 741166 and go to the Accident and Emergency Department at the John Radcliffe Hospital if deemed appropriate by the microbiologist
  4. in the event of a large animal bite go straight to the Accident and Emergency Department at the John Radcliffe Hospital
  5. Always inform the OHS of the incident as soon as possible and no later than the next working day so that any necessary follow up health assessment and support can be initiated.

Please note

Always inform the OHS of the incident as soon as possible and no later than the next working day so that any necessary follow up health assessment and support can be initiated.