PROTOCOL FOR NEEDLE STICK INJURY

1. IMMEDIATE
1.1 FOR INJURY : Wash with soap and running water
1.2 For Non intact Skin Exposure : Wash with soap and water
1.3 For mucosal Exposure : Wash thoroughly
2.

All sharps injury and mucosal exposure MUST be reported to the immediate supervisor, and to the casualty
Medical officer to evaluate the injury. Details of the needle-stick should be filled by the supervisor and handed
over to the nurse for the further follow-up.

3.

Management
Management is on case to case basis

4.

Follow-Up
Follow-up and statistics of needle-stick injury are done by the HIC nurse on a weekly basis. This information is
presented at the HICC meeting and preventive actions to avoid needle-stick injuries, if any, are recorded.

5.

Post-HIV Exposure Management / Prophylaxis(PEP)

It is necessary to determine the status of the exposure and the HIV status of the exposure source before starting
post exposure prophylaxis(PEP)

6.

Immediate Measures
6.1
Wash with soap and water
6.2
Do not use antiseptic or bleach

7.

Next Steps
7.1 Prompt Reporting
a) All needle-stick/sharp injuries should be reported to the immediate supervisor
b) An entry is made in the Needle-Stick Injury Register in the Casualty
Post exposure treatment should begin as soon as possible preferably within two hours, and is not recommended
after 72 hours.
PEP is not needed for all types of exposures.

POST EXPOSURE PROPHYLAXIS

Immediate Management of NSI and BBF exposures

Bleeding should be encouraged

Wound should not be squeezed. This is the most important.
Wound should be thoroughly washed in running water with soap.
Mucous membranes should be flushed thoroughly with water (no soap)
Eyes should be irrigated with a liter of saline.
Consult the institution designated physician immediately for further management.

HEPATITIS-B
Post exposure prophylaxis to prevent Hepatitis-B infection in case of NSI BBF,(CDC)
Vaccination and antibody
status of the exposed
person

Unvaccinated
Known
responder
(Anti-HBs >
10mlU/ml)
Known nonresponder
(Anti-HBs <
10mlU/ml)

Previously
vaccinated

Antibody
response
unknown

TREATMENT
Source HBs Ag +ve

Source HBs Ag -ve

Source unknown or not

available for testing

HBlg(0.06ml/kg lM) and

initiate HB vaccine series
(0,1,6)

Initiate HB vaccine
series(0,1,6)

Initiate HB vaccine
series(0,1,6)

No treatment

No treatment

No treatment

HBlg(0.06ml/kg lM) and

initiate revaccine

No treatment

If known high risk source,

treat as if source were HBs
Ag +ve

No treatment

Test exposed person for

anti HBs
1. if adequate no treatment
2. if inadequate than
administer HB vaccine
booster dose and then
recheck titer in 1-2 month

Test exposed person for

anti HBs
1. if adequate no treatment
2. if inadequate than
administer HBlg and HB
vaccine booster dose