Needle Prick Injury

Universal Infection control precautionAll 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 precautionBlood, 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 precautionRisk 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 precautionUniversal 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 precautionBody fluids which may contain other pathogenic microorganisms: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 precautionProtective 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 precautionProtective 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 precautionProtective 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 InjuryProtection and ImmunizationAll 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 InjuryIntravenous 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 injuryCollection/transportation of bloodMinimum 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 injuryCollection/transportation of bloodTransfer 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 injuryGUIDELINES FOR HEALTH CARE WORKERS WHO HAVE BEEN EXPOSED TO BLOOD, BLOOD PRODUCTS AND BODY FLUIDS OF PATIENTS POSITIVE FOR HIV

Needle prick Injury1.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 woundunder running water for minimum of 5 mins and clean with chlorhexidine

Needle prick Injury3. 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 Injury4. History should be recorded confidentiallya) 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

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Needle prick injury5. Monitoring/evalution of Health Care workerStaff 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 injury5. 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