Needle stick Injury (NSI)

to needles are at increased risk

Healthcare personnel who use or may be exposed
lead to serious or fatal infections
of needlestick injury. Needlestick injuries
can
HIV
hepatitis B virus, hepatitis C virus,
or
with bloodborne pathogens such as

PROTOCcOL
1. Immediate
and rinse. Do not
For Injury: Wash with soap and running water,
scrub.Do not use antiseptics or skin washes (bleach, chlorine,
alcohol,
betadine).
For Non intact Skin Exposure: Wash with soap and wateer.

For Mucosal Exposure: Wash thoroughly.

2. Reporting
1. All mucosal exposure MUST be reported to the
sharps injury and
immediate supervisor, and to the Casualty Medical Officer to evaluate
theinjury.Details of the needle-stick injury should be filled by the
handed to the HIC nurse for further follow-up.
supervisor and over

3. Management / Post Exposure Prophylaxis (PEP)

4. Counselling for PEP

Exposed (clients) should receive info. about PEP & risk &
persons
benefits of PEP (to provide informed consent for taking PEP). It should
beclearthat PEPis not mandatory.
5. Follow-Up
.Clinical follow-up
Laboratory follow-up
Exposed persons should have post-PEP HIV tests.

HIV-test at 3 months and again at 6 months is

recommended.

Ifthe test at 6 months is negative, no further testingis

recommended.

6.Psychological support
 AA ilejy. elASSMAte

TABLE 12.3.4 POTENTIALLY INFECTIOUS BODY FLUIDS

Exposure to body fluids Exposure to body fluids

considered 'at risk' considered 'not at risk'

Blood Tears Unless

these
Semen Sweat secretions
contain
Vaginal secretions Urine and Faeces visible

blood
Cerebrospinal fluid Saliva

Synovial, pleural, peritoneal,

pericardial fluid

Amniotic fluid

Other body fluids contaminated

with visible blood

Don'ts:
Do not panic
Do not put pricked finger in mouth
D o not squeeze wound to bleed it
Do not use bleach, chlorine, alcohol, betadine, iodine or any antiseptic
or detergent
 PEP
Decision to start PEP made on the basis of : degree of exposure to HIV & HIV
status of the source.
Should begin as soon as possible:
First PEP dose within 72 hours
ideally within two hours but certainly within 72 hours;
PEP is not effective when given more than 72 hours after exposure.
The first dose of PEP should be administered within the first 72
hours of exposure.

Basic PEP regimen ( 2 drug Zidovudine + lamivudine X4 wks

combination)
Expanded regimen ( 3 drug Zidovudine + lamivudine +lopinavir X4 wks

combination) (orritonavir)
PEP is not needed for all types of exposures:
The HIV seroconversion rate of 0.3% after an AEB (accidental exposure to
blood) (for percutaneous exposure) is an average rate.

Risk ofinfection transmission a Amount of HIV transmitted

.A baseline rapid HIV testing of exposed and source person must be done for
PEP.
.However, initiation of PEPshould not be delayed while waiting for the
results of HIV testing of the source of exposure. Informed consent should be
obtained before testing of the source as per national HIV testing guidelines.
 HIV Exposure code

Is the source material blood, bloddy fluid or

other potentially infected
material (OPIM) or an instrument contaminated
with one of these substances?

No PEP
Yes No required

What type of exposure has occurred?

Mucous membrane Irtact skin ony Percutaneous

or skin integrity exposure
Compromised
NoPEPTegured
HIV Source code
Severity
Volume
HIV status of exposure source

Small volume- Large volume- Less More

HN negatve HIV POSiUy Status/Source unknown major splash severe- severe-
few dropssl solid hollow
short duration long duration
needle bore,
No PEP ecuir HIV SCunknowin Superficial deep
scratch injury
te exposureHentre EC1

Nhco NAKeo EC2 EC 3

etermining PEP recommendation

endation
EC HIVsC
warranted
May not be
1
Consider basic regimen (Two drugs)

Recominend basic regimen(Twodrugs)

wnewsnenn

expanded regimen
(Three drugs
Recommend
2
drugs)
Recommnend expanded regimen(Three
w
HIV prevalence iS
Consider basic regimen i
2/3 hign high in the given populaion

NAÇO
Recommendations ior POst-exp0sure propr
g. 61.10
laxis (PEP
 Barabankl
Mayo Institute of Medical Sciences,
Name of Hospital:

District: Barabanki Date:

FORM
NEEDLE 8TICK INJURY
Remark
Parameteors
Sr.
No.
Worker (HC
1. Name of Hoalth Care
Department
2. Nameof the Unlt &

3. Date and Tme of Needie

Stick/Sharp Injury
to ICN
4 Datoand Time of Reporting
5. Siteof Injury

6 Natyre.ofInjury Needle Prick/Sharp"

CutLacerations/Splash
ofFluids Splattered
Glass/Others(Please speclty)

7. Sourceoflnjury (FAvallablo)
8. Action taken on sitë
Yes/No
9. Pre-exposure Prophylaxis given
10, Date Time& Type of Vaccinatlon
11 Whether vacclnaton taken after Yes/No
exposure
12 If taken after exposure Date Tinia
and Type of Vacclnatlon
13, f nottaken after exposure reasons
for the same
14, Test Results after expogure with
I method used,

Filled By Submittedto
Action Y

Taken

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