Needle stick injury

What counts as an exposure

Occupational exposure, as MOH, Department of Communicable Diseases defines it in HIV management in Oman, 3ed edition 2015, is exposure to blood or body fluids that occurs during the course of an individual's employment, by one of three routes:

• Percutaneous: a needlestick or a cut with a sharp object
• Mucous membrane: eye, nose and mouth
• Non-intact skin: exposed skin that is chapped, abraded, or afflicted with dermatitis

Two of the three routes are not needles at all. Blood in the eye is the same event as a needlestick and starts the same steps.

It mainly applies to health care workers in health care settings; however other workers may also be exposed, and the ones named are emergency rescue staff, waste disposal workers, law enforcement personnel and fire fighters.

What is done first

The worked case is a doctor who sustained a needle stick injury from an IV drug abuser seen in the emergency department, and the question asked is what the first steps to be done immediately are.

For the eye route the same question is asked, of blood from a needle in the eye, and two answers are given side by side: report incidence, or irrigation and clean eyes. Both belong, and reporting stands as an answer in its own right, because the report is what starts the testing and the prophylaxis.

After initial wound management comes the source patient, not the worker.