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.
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:
- PEP Quick Guide for Occupational Exposures – These NCCC post-exposure prophylaxis (PEP) recommendations on testing and PEP will help you with urgent decision-making for occupational exposures to HIV and hepatitis B and C. And you can call for a consult if you still have questions!
- Emergency Sharps Information from the CDC
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
- What to Do If Your Child Is Exposed to Hepatitis B
- Don’t Skip Your Baby’s Hepatitis B Shot
- 5 Myths About Tetanus and Tetanus Shots
- Ingested vs. Injected Vaccine Myths
- Why Can’t You Give Blood After Getting a Vaccine?
- MMWR – Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis
- MMWR – CDC Guidance for Evaluating Health-Care Personnel for Hepatitis B Virus Protection and for Administering Postexposure Management
- PEP: Post-Exposure Prophylaxis
- Federal and best-practice recommendations for post-exposure prophylaxis (PEP) decisions
- Tools to Help You Manage Exposures to HIV and Hepatitis B and C
- OSHA Injury and Illness Recordkeeping and Reporting Requirements
- OSHA – Injury & Illness Recordkeeping Forms 300, 300A, 301
- CDC – State-by-State Provisions of State Needle Safety Legislation
- Found Needle PEP
- PEP Tips on Baseline Testing
- PEP Tips on Follow-Up Testing One Year After an Exposure
- Deciding Whether to Give HIV PEP
- How to choose a PEP regimen?
- CCC Guidance for Pediatric HIV PEP Outside of the Perinatal Period
- Case of the Month: Needlesticks, HIV+ Source Patients, and PEP
- Case of the Month: Exposure Management: Labor and Delivery and Breastfeeding
- Case of the Month: Needlestick PEP in a Correctional Setting
- National PEPline Recommendations on Percutaneous Exposures to SARS-CoV-2 in Occupational Settings
- Management of sharps injuries in the healthcare setting
- IAC – Ask the Experts about Hepatitis B Vaccines
- IAC – Ask the Experts about Administering Vaccines
- AAP – Injuries From Discarded Needles in the Community
- Needle stick injuries in the community
- OSHA – Healthcare Wide Hazards Needlestick/Sharps Injuries
- CDC – Preventing Needlesticks and Sharps Injuries
- American Nurses Association’s Needlestick Prevention Guide
- Needlestick and Sharps Injuries Fact Sheet (Canada)
- What should I do if I injure myself with a used needle? (UK)
- Needle stick injury (Australia)