Sun28November0440PM 6

During the insertion of an intravenous cannula in an anaesthetised patient you sustain a needle stick injury. The wound is immediately encouraged to bleed and washed with soap under running water.

What is the most important next step for you to take?

(Please select 1 option)

Complete a critical incident form according to local guidelines

Commence appropriate anti-retroviral medication

Assess the patient's risk factors for blood-borne viruses

Take blood from the patient for HIV & hepatitis B & C testing

Get baseline bloods taken from yourself for viral serology Correct

Explanation

The major bloodborne pathogens of concern associated with needlestick injury are:

hepatitis B virus (HBV)

hepatitis C virus (HCV)

human immunodeficiency virus (HIV).

If the needle has penetrated the skin it is regarded as a high-risk injury. You are now a patient and should be referred to Occupational Health (during normal hours) or the Emergency Department (out of hours).

A blood sample should be taken from you as soon as possible and sent to a virology or microbiology laboratory for serum to be saved and stored.

A source patient risk assessment should be carried out by an experienced health care professional (Senior nurse or doctor from the clinical team caring for the patient as soon as possible (ideally within 30 minutes). The injured health care worker must not carry out the source patient risk assessment. Inform Occupational Health or out of hours Emergency Department whether or not a source patient risk assessment has been arranged and provide them with contact details of the person carrying out the risk assessment. Once a risk assessment has been made a decision whether to start post-exposure prophylaxis (PEP) will be made.

It can be very helpful to test source patients, with their informed consent, for HIV, HBV and HCV, regardless of risk factors, unless very recent results are available. Most source patients consent to testing when the policy is explained. The patient is anaesthetised and so taking blood without their consent is not an appropriate action.

Once a risk assessment has been made and blood from the exposed person has been taken, a critical incident form can be filled in.

Answer Statistics

1

32%

2

2%

3

25%

4

12%

5

31%

Times answered: 294