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Needlestick/Sharps Injury

A skin puncture caused by a hypodermic needle or sharp or broken item of equipment (e.g. scalpel, mounted needle, broken glassware, etc.) A needlestick injury is of concern because of the risk of transmission of blood-borne viruses (HBV, HCV, HIV). Most common cause in healthcare professionals is attempted re-sheathing of needles. If the sharp was used or dirty:

  • Encourage wound to bleed, to expel contaminants
  • Wash with soap and warm water. Do not scrub. Do not use antiseptics
  • Dry and apply waterproof plaster
  • Report to supervisor/senior midwife immediately
  • Assess risk - contact occupational health or local consultant in communicable disease control/consultant microbiologist/virologist or genitourinary medicine or A&E
  • Complete accident form.

See Immunisation against Infectious disease (the Green Book) [hyperlink to https://www.gov.uk/government/publications/hepatitis-b-the-green-book-chapter-18 ] for prophylaxis and procedure where there is substantial risk of blood-borne infection (e.g. hepatitis B), also for primary and reinforcing immunisation. Hepatitis B prophylaxis HBV immunoglobulin (HBIG) confers passive immunity and gives immediate but temporary protection after accidental inoculation or contamination with HBV-infected blood. HBIG is recommended only in high-risk situation or a known non-responder to vaccine. Should ideally be given with 24 hours of exposure, but can be considered at up to 1 week. An HBV vaccination course confers active immunity. If an unprotected individual is at high risk of infection, the vaccine can be given at the same time as HBIG.

 

Further reading

Health & Safety Executive (2013) Sharps injuries http://www.hse.gov.uk/healthservices/needlesticks/

Public Health England (2014). Eye of the Needle: United Kingdom surveillance of significant occupational exposure to bloodborne viruses in healthcare workers. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/385300/EoN_2014_-_FINAL_CT_3_sig_occ.pdf

Bandolier. Needlestick injuries http://www.medicine.ox.ac.uk/bandolier/booth/booths/needle.html

Public Health England. Immunisation against infectious disease (the Green Book). https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book

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