Needle Stick Injury Tutorial PDF

Medical microbiology and immunology department (Tutorial) Learning objectives Identify diseases that can be transmitted by needle stick. Describe postexposure prophylaxis measures( PEP). Differentiate between different postexposure prophylaxis measures. Identify hazards of need...

Medical microbiology and immunology department (Tutorial) Learning objectives Identify diseases that can be transmitted by needle stick. Describe postexposure prophylaxis measures( PEP). Differentiate between different postexposure prophylaxis measures. Identify hazards of needle stick injury.  Case Amani is a head nurse. One afternoon, as Amani was almost ready to go, she approached the young patient. She performed hand hygiene, put on clean gloves, successfully drew the sample after skin disinfection. With her hand, she reached for the sharps container behind her; it was full, causing her to be stuck by another needle. Since she was already late, she felt she only had time to wash her hands with soap and water and make a note of what happened. She rushed off without reporting her injury to her supervisor. She knew that Hepatitis B (HBV) and other bloodborne diseases can survive outside of the human body for an extended period of time, but she assumed that the risk of getting infected was low because the needle had been dry for a while. Imagine for a moment that you are in Amani’s position. What would you have done?  A needle stick (prick) injury means the skin is accidentally punctured by a used needle. Blood-borne diseases that could be transmitted by a needle stick injury include human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV).  Risk of transmission of bloodborne pathogens after needle stick injury HBV: 30% HCV: 3% HIV: 0.3% What to do in case of a needle-stick injury If you pierce or puncture your skin with a used needle, follow this first aid advice immediately: encourage the wound to bleed, ideally by holding it under running water wash the wound using running water and plenty of soap do not scrub the wound while you're washing it do not suck the wound dry the wound and cover it with a waterproof plaster or dressing  Immediately inform your supervisor. Be sure to follow the needle-stick injury reporting protocol for your health facility. If possible, identify the source patient and test for HIV, hepatitis B and hepatitis C after providing counselling and obtaining informed consent. It is recommended, to test for HIV, hepatitis B and hepatitis C.  Hepatits B post-exposure Prophylaxis (PEP) If an injured health worker has not been vaccinated: ❑ Initiate and complete vaccination with hepatitis B immune globulin within 48 H ❑ All scheduled doses of the vaccination series should be completed even if the source of exposure is hepatitis B negative. ❑ Follow-up of HBV exposure : If the health worker received the vaccine after the injury, test for antibody formation against the vaccine one to two months after vaccination. If HBIG was given in combination with the vaccine, you cannot determine if antibodies formed in response to the vaccine within this period <  Hepatitis C post-exposure HCV is rarely transmitted from exposure of mucous membranes or nonintact skin to contaminated blood Perform baseline testing for antibodies, as well as alanine aminotransferase (ALT) blood testing. At 4 to 6 months after exposure, retest the exposed person for antibodies and ALT. For early diagnosis, test viral RNA 4 to 6 weeks after exposure. If HCV antibodies turn positive enzyme immunoassay (ELISA) results, supplemental tests may be needed. If infection is identified, the exposed person must be referred to a specialist for treatment  Management of exposure to HIV HIV can survive in dried blood at room temperature for up to three days Refer the person exposed to the risk of transmission to a trained person for medical evaluation, risk assessment and prescription of PEP. PEP (post-exposure prophylaxis) means taking medicine to prevent HIV after a possible exposure The decision on whether or not to take PEP should be based on the recommendations and counselling on adherence and on the possible adverse reactions to the antiretroviral drugs.  Administer the antiretroviral drugs for PEP as soon as possible after the exposure (ideally within 4 hours, max 72 hours); Continue the PEP regimen for 28 days. Test for HIV antibodies at baseline, 6 weeks, 3 months and 6 months after exposure. if seroconversion occurs, refer the exposed person for treatment, care and support.  Ways to reduce the risk of needlestick injuries Health workers who may come in contact with blood or body fluids should receive hepatitis B vaccinations. Follow all safety procedures in the workplace. Regularly undertake safety refresher courses. Minimise your use of needles. Remember that latex gloves don’t protect you against needlestick injuries. Don’t bend or snap used needles. Never re-cap a used needle. Place used needles into a clearly labelled and puncture-proof sharps approved container.  Assessment 1- Which of the following blood-borne pathogens has the highest risk of needle stick injury transmission? a. Hepatitis B virus. b. Hepatitis C virus. C. HIV virus.  Assessment 2- HIV can survive in dried blood at room temperature for which of the following? a. Two days. b. Seven days. c. Three days  Assessment 3- Explain the management to be done after needle stick injury.  References https://www.cdc.gov/hiv/basics/pep.html THANK YOU