Needlestick injuries

The risk of transferring infection depends on the virulence of the organisms present, the size of the infecting dose, and the state of the recipient's immune system. Infection with HIV following a 'sharps injury' is less than 0.5 per cent, whereas the risks of acquiring hepatitis B and hepatitis C viruses with a similar injury are 6 to 30 per cent and 2.7 to 10 per cent respectively. These risks are increased (up to five times) in units associated with the treatment of liver disease and transplantation. Techniques to reduce 'sharps exposure' include the following ( Berry..and..lGreene 1992).

1. Eliminating non-essential unprotected needle use by the use of needleless or protected-needle devices and by modifying the procedures requiring needles to minimize the risk.

2. Using ports within intravenous cannulas that allow syringe connection without the use of needles.

3. Using plastic ampoules and blunt drawing-up needles to reduce skin perforation.

4. Using self-capping needles and educating staff on the hazards of resheathing needles to reduce the risk. When needles must be resheathed, a one-handed technique should be taught.

5. Continuous intra-arterial blood gas monitoring and closed systems for venous blood sampling should be used to reduce exposure to blood.

6. Potentially hazardous items should be placed, by their user, in separate rigid disposal containers before incineration. Such 'sharps bins' should be readily available.

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