From the Guidelines
The needle stick protocol involves immediate action after exposure to potentially contaminated needles or sharps, including washing the wound with soap and water, reporting the incident, and seeking medical evaluation within 2 hours, as outlined in the guidelines from the Centers for Disease Control and Prevention 1.
Key Steps in the Protocol
- Wash the wound thoroughly with soap and water for at least 15 minutes, or flush mucous membranes with water.
- Report the incident immediately to your supervisor and seek medical evaluation within 2 hours.
- Blood tests will be conducted for both you and the source patient (if known) to check for HIV, hepatitis B, and hepatitis C.
- Post-exposure prophylaxis (PEP) may be recommended based on risk assessment, with a 28-day course of antiretroviral medications like Truvada (tenofovir/emtricitabine) plus Isentress (raltegravir) or Tivicay (dolutegravir) for HIV exposure, and HBIG (hepatitis B immune globulin) and vaccination for hepatitis B if you're not immune.
Importance of Prompt Action
Prompt treatment significantly reduces transmission risk, with HIV PEP reducing risk by over 80% when started quickly, and hepatitis B prophylaxis being highly effective when administered appropriately, as noted in the updated guidelines from the U.S. Public Health Service 1.
Follow-up and Documentation
Follow-up testing occurs at 6 weeks, 3 months, and 6 months post-exposure, and all details of the incident, including date, time, circumstances, and source patient information, should be documented, as emphasized in the guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis 1.
From the Research
Needle Stick Protocol
- The protocol for needle stick injuries involves immediate reporting and treatment to minimize the risk of transmission of blood-borne pathogens such as HIV, hepatitis B and C viruses 2, 3, 4, 5.
- The Centers for Disease Control and Prevention (CDC) recommends HIV postexposure prophylaxis (PEP) for healthcare workers exposed to HIV-infected patients, which consists of a cocktail of antiretrovirals and postexposure prophylaxis immediately after occupational exposures, such as accidental needlestick exposure 2.
- Follow-up monitoring of needle stick injuries is crucial for early recognition of transmission of HIV, HCV, and HBV, as well as adherence and psychological burden of healthcare personnel 3.
- Safety precautions, such as proper education and training, can help reduce the incidence of accidental needle stick injuries 2, 5.
- Postexposure prophylaxis (PEP) should be initiated as soon as possible, ideally within 2 hours of exposure, to minimize the risk of transmission 3, 5.
- Healthcare workers who experience a needle stick injury should undergo serological testing to determine their infection status and receive appropriate treatment 3, 5.
Prevention and Management
- Preventive measures, such as the use of safety needles and proper disposal of sharps, can help prevent needle stick injuries 4, 5.
- Healthcare facilities should have a reporting system in place for needle stick injuries to ensure prompt treatment and follow-up 5.
- Education and training on needle stick prevention and management should be provided to healthcare workers to minimize the risk of transmission 2, 5.
- The management of needle stick injuries should include immediate reporting, treatment, and follow-up to minimize the risk of transmission and ensure optimal care for the affected healthcare worker 5.