Managing sharps injuries

by Will Stahl-Timmins
illustrations by Katie Jessop 27th July 2015
• Don’t scrub wound
Gently Wash with ✘ • Don’t use antiseptic
encourage soap and
bleeding water

1
First Wash eyes
before and after
aid removing contact
Mucosal exposure lenses
wash copiously Cover with
with water or impermeable
saline dressing

Incident risk: High Low Minimal

Injury Deep Superficial No skin breach

2 Needle use Intravascular

Suturing/ Not used
Subcutaneous on patient
Assess Age of sharps Recently used Old, discarded Contact with
incident low risk fluids:

risk Blood on sharps Visible Not visible Saliva

Urine
Vomit
Faeces

Is the source patient known to be infected

with one or more blood borne viruses? No further

3
action
Yes No
required

Assess Viral load Do risk factors apply?

source Detectable Unknown Fully suppressed
e.g. Injecting drug users, men who
have sex with men, sex workers
patient Yes No
for blood borne
viruses. HIV, Treatment status
Hepatitis B Untreated / Unknown Long term Recent blood test
(HBV) and advanced treatment, negative for HIV, HBV & HCV
hepatitis C infection good adherence No Yes
(HCV) are the
most common.
Post-exposure High risk Low risk
prophylaxis exposure exposure
(PEP) and/or
follow up HIV HBV HCV
treatment Begin immediate PEP Check vaccine Follow up and No further
may be with antiretroviral agents status treat if necessary action
required
required. See table 2 See table 3 See table 4

The full BMJ clinical review on sharps injuries is available at: http://bmj.co/sharps © 2015 BMJ Publishing group Ltd.