Needle Prick Injury

Universal Infection control

precaution
All patients' body fluids should be treated as infectious,
since it is not known who is infected and carry a
pathogen
Prevent the exposure and infection of health care
workers from blood-borne pathogens
To isolate the virus and body fluids and not the patient
 Universal Infection control
precaution
Blood, body fluid – contain blood-borne
viruses,bacteria
Risk to patient arises from:-
1. Use of recycled hollow needle and
syringes
2.Contaminated blood transfusion
3.Heavy soiling of enviroment
4. Poor ward facilities and cleaning
 Universal Infection control
precaution
Risk to medical personal arises from:-
1. sharps and hollow needles
2. splashing of conjunctive/mucous membrane with
contaminated blood and body fluids
3. heavy contamination of broken skin,eg cuts,dermatitis
4. handling of large quantities of blood,body fluids
without protective clothing.
 Universal Infection control
precaution
Universal infection control precautions apply to:
Body fluids which may contain HIV or Hepatitis B:
Blood
Blood-stained body fluids
Semen
Vaginal secretions
Tissues
CSF, amniotic, pericardial, pleural fluids etc
 Universal Infection control
precaution
Body fluids which may contain other pathogenic micro-
organisms:-
Faeces,Urine,Vomit,Sputum
Universal infection control precautions do not apply to body
fluids which are unlikely to contain pathogens such as:-
Tears,nasal secretions,sweat and saliva
 Universal Infection control
precaution
Protective clothing:
recommended when there is a risk of contamination by
blood, body fluids and tissue
When particular high risk procedures are performed.
There are basically two systems being practised.
- A two-tier system : Only for known high risk cases in
area of low incidence of blood borne diseases
- A single-tier sytem: For all patients ,when the incidence
is high
 Universal Infection control
precaution
Protective clothing:
Gloves – for direct contact. Idealy latex, fit
well and disposable
Plastic apron- to protect from body fluids,
disposable
Eye protection – goggles, to prevent
conjunctival splash contamination.
Mask – to protect mouth and nostrils
 Universal Infection control
precaution
Protective clothing:
Broken skin – to cover cut/abrasion on
hands and forearm with waterproof
dressing
Handwashing - the single most important procedure
to prevent hospital-acquired infections.
Two types, social hand washing and
aseptic hand washing.
 Needle prick Injury

Protection and Immunization

All staff working with hepatitis B and HIV patients must
be immunized against hepatitis B.
Adequate training in the care of patients who are HIV
or hepatitis B - positive and should be aware of
the risks involved.
Clear policies of safety, covering inoculation accidents
must be available. All inoculation accidents
reported and documented.
Frequent lectures to allay feaR,promote good morale
 Needle prick Injury

Intravenous procedures:
Performed by experienced practitioner
Need to wear gloves, plastic aprons, eye
protection is optional
A closed system(Vacutainer) is
commended.
Hypodermic needle and syringe should be
discarded in sharp container.
 Needle prick injury

Collection/transportation of blood
Minimum no of test on high risk patients
Collect specimen with secure container,
label clearly,put in leak proof bag with
request form
Wear double gloves for high risk patients
Place a paper towel beneath pt's arm to
avoid accident blood spillage
Discard soiled paper towel/gauze - clinical
 Needle prick injury

Collection/transportation of blood
Transfer the blood slowly to an appropriate
container slowly and carefully without
creating an aerosol
NEVER re-cap the needle, discard in sharp
container
 Needle prick injury

GUIDELINES FOR HEALTH CARE WORKERS WHO

HAVE BEEN EXPOSED TO BLOOD, BLOOD
PRODUCTS AND BODY FLUIDS OF PATIENTS
POSITIVE FOR HIV
 Needle prick Injury

1.Types of Exposure of Injury To Be Considered

a) Percutaneous injury (deeper than epidermis) e.g.
needle stick, cut with sharp object.
b) Mucous Membrane Contact
c) Skin that is chapped, abraded or has dermatitis
2. Immediate actions to be taken- press the cut wound
under running water for minimum of 5 mins and clean with
chlorhexidine
 Needle prick Injury

3. Current HIV status of patient and

medical staff.
a) Patient is HIV negative – may not need treatment
b) Patient is HIV positive - prophylaxis due to high
risk of HIV
 Needle prick Injury

4. History – should be recorded

confidentially
a) Date and time of exposure
b) Duty performed at time of exposure
c) Details of exposures – amount /type/severity of
exposure
d) Describe the source of expose, whether the
patient is HIV positive
e) Details abt counselling,post exposure magement
and followup
Needle prick injury

Thank you
 Needle prick injury

5. Monitoring/evalution of Health Care

worker
Staff clinically and serologically evaluated for HIV
infection
a) As soon as possible after exposure( as
baseline)
b) If HIV test negative, re-test after 6 weeks, 12
weeks and 6 months after exposure
c) Staff clinically followep up and acute illness
noted
d) Should not donate blood/semen/organ for 12
 Needle prick injury

5. Monitoring/evalution of Health Care

work.
e) Carry out Haematological and Liver function
test at each followup
f) Look for drug toxicity and side effect.
6. Reporting Every exposure to HIV infected
material should be reported to AIDS/STD section,
Disease Control Division Ministry of Health with
a copy to Medical Services Division for
surveillance of workers with occupational
exposure to HIV. No names or personel