Neobook — clinical reference

Remove glove immediately following a needle prick or sharp injury and encourage bleeding of the wound.
Wash under a tap with antiseptic soap or a hypochlorite solution. Spontaneous bleeding indicates a deep injury. Apply a dressing.
Obtain a witness to the injury usually the ward sister.
Report to casualty for examination and treatment.
Baseline bloods will be sent which include – HIV, RPR, Hep B and C.
If source person’s status is unknown arrange with his/her doctor to obtain blood with consent for HIV, RPR, Hep A, B and C. The costs of these bloods to be covered by the hospital.
Injured staff member to be treated as COIDA non-paying patient. Compensation for injuries on duty forms have to be completed and affidavits sworn in front of a commissioner of oaths.
The casualty officer must complete the first medical report and makes notes on file detailing the nature of the injury.
Complete forms for surveillance of needle -stick injuries. Make sure that Infection Control is informed of the incident so that accurate statistics are kept.
If the source patient is positive then bloods need to be repeated on injured staff at 6 weeks, 12 weeks and every 2 months until 6-12 months after exposure.
Prophylaxis should be ordered according to risk of exposure and must be taken ideally within one hour of exposure. This should be Truvada ® (Tenofovir + FTC) AND a third agent such as Lopinavir/ritonavir OR Raltegravir OR Atazanavir/ritonavir, which initial stat doses should be available in overnight cupboard in casualty. The remaining course will be obtained from the pharmacy on a weekly basis.
For Hepatitis B known or unknown source of needle-stick injury, immunoglobulin should be given (unless you are aware of your Hepatitis B immune status).
For counselling and support, the staff member could contact infection control at 011 470-9169. Benefits and side-effects of drugs could be discussed with pharmacist or counsellor of your choice.
Social workers act as commissioners of oath.
Infection Control sisters to be contacted at Ext 9078/9306.

Needlestick or Sharp Injury

Drugs mentioned