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Protocols for Managing Needlestick Injuries

Although everyone tries to be as careful as possible when they are around vaccines and needles, there might come a time when you get stuck with a used needle.

In addition to making sure you don't overfill your sharps container, you can prevent needlestick injuries by never recapping needles and using safety needles.
In addition to making sure you don’t overfill your sharps container, you can prevent needlestick injuries by never recapping needles and using safety needles.

Will you know what to do?

The Risks from Used Needles

Let’s start with why you should work to prevent needlestick injuries and what you might put yourself at risk for if you get stuck with a used needle, including:

  • hepatitis B (are you vaccinated and immune?)
  • hepatitis C
  • HIV

While you don’t want to get any of those blood borne infections, the good news is that the risk really isn’t that high in most circumstances, especially after giving a SQ or IM vaccine (generally no blood) with a smaller needle.

What raises your risk?

Getting stuck with a used needle that was just used on someone with hepatitis B, hepatitis C, and HIV, etc, especially if it is a deep wound and there was visible blood on a larger hollow-bore needle.

Protocols for Managing Needlestick Injuries in the Office

So what do you do if someone gets stuck with a used needle?

  • secure the used needle
  • wash the area with soap and water
  • dress the wound
  • assess the risk for blood borne virus transmission

Assess the risk for blood borne virus transmission, which includes HIV, hepatitis B, and hepatitis C?

“The actual risk of transmission during an incident depends on several factors, such as the type of injury, the viral load of the source patient, the immune status of the recipient, and risk reduction strategies implemented in the healthcare setting.”

Management of sharps injuries in the healthcare setting

Can’t you just do some blood tests and figure out if the person is at risk???

Maybe, but understand that when thinking about these risks, what you are really trying to figure out is whether or not you have to quickly start the person who was stuck with a needle on any post-exposure prophylaxis.

“PEP is generally not warranted when the source person is unknown. However, consider PEP in settings where exposure to HIV positive source persons is likely.”

Deciding Whether to Give HIV PEP

And that has to be done quickly – within hours in many cases if it is necessary.

These guidelines will help you make that decision:

Guidelines that your office hopefully already has in their own policy and procedures manual.

And don’t forget to record and report the needlestick injury to OSHA and per any requirements of state law.

Other Protocols for Managing Needlestick Injuries

What if you are stuck with a used needle outside your home, like in a park or on the bus?

Understand that these are generally low risk exposures, but you should seek immediate medical attention to have labs drawn and to see if PEP is required, as there is still some risk for hepatitis B, hepatitis C, and HIV.

More on Protocols for Managing Needlestick Injuries

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