infection control ,medical , health care worker,

1. NEEDLE STICK INJURY
- DR SHRUTIKIRTI

2. Occupational exposure- (In health care setting )
Exposure to potential blood borne infection that may occur
in health care setting while performing duties
1. Percutaneous injury/ needle stick injury
2. Splash injury with blood and body fluids
Post exposure prophylaxis
Comprehensive medical management to minimize the risk
of infection among health care worker following exposure

3. Health care setting
Exposure
Occupational non occupational
Exposed person – person who is potentially at risk of acquiring
infection
Source person (identified/unknown) – patient – Possible source
of infection
1. Percutaneous injury (needle stick injury
(NSI) / metal sharps
2. Splash injury with blood or body fluid
exposure
Exposure outside work place
Unsafe sex , sexual assault,
human bite

4. Potential blood born infection-
HBV (9-30%)
HCV (1-1.8%)
HIV(0.3%)
Infectious specimens for NSI
1.Potential infectious specimen
2.Potentially non infectious specimen

5. RISK-
WHO?
WHEN?
WHERE?

6. Risk factor
 Unsafe practices(reuse, recap, overuse, unsafe sharp waste management)
 Other
1) Type of needle – hollow bore>solid
2) Device contaminated with blood
3) Depth of injury volume of blood
4) Viral load
5) Delay in first aid and PEP
Device a/w NSI

7. CHALLENGES
 Most neglected and under- reported
 Lack of network and database maintenance
PREVENTION

8. Management- post exposure prophylaxis
Steps-
 First aid
 Report to nodal centre
 1st dose of PEP for HIV
 Lab testing for BBV
 Decision on PEP for HIV & HBV
 Documentation and recording
 Consent and counselling
 Follow-up
 Precaution during follow-up

9. Laboratory testing-
1. Anti- HIV antibody detection
2. HBsAg detection
3. Anti- HCV antibody detection
4. Anti HBs antibody
Baseline serostatus – should be obtained with in 6 days of
exposure
Risk assessment
HIV – risk of transmission - up to 48hr
HBV- risk of transmission- up to 7 days

10. Level of
exposure
???

12. HIV – prophylaxis
Zidovudine
Lamivudine
Lopinavir/ritonavir/efavir
enz
Window period –
High prevalence area- PEP given
Low prevalence area- PEP not
given

13. HBV Prophylaxis -

14. THANK YOU