Admin

Question 1

Needlestick injuries

Answer 1

Risks following exposure
- Hep B 30% transmission
- Hep C 3% transmission
- HIV 0.3% transmission

Information from patient
- HIV viral load detectable/undetectable
- current treatment
- HCV or HBV status
- bloods for screening

What factors increase risk
- time, mechanism, no gloves, needle from vein/artery, blood visible on device, deep puncture, contaminated material
- IVDU, MSM, AIDS defining illness, known blood borne infection

Factors that decrease risk of transmission
- gloves worn, wound bled and irrigated, confirmed HBV immunity

Assessment and management:
First aid, irrigate
Assess wound and cover
Full history
Assess feelings of patient
Consent for investigations:
- Donor - serology for HIV and hepatitis
- Recipient - serology for HIV, hep, LFTs
Refer to occupational health

Question 2

Principles of team leadership

Answer 2

Allocate roles and ensure staff comfort
Shared mental model
Closed loop communication
Open for questioning
Verbal recaps
Opportunities for feedback
Crowd control

Question 3

Consent and capacity

Answer 3

Consent
- freely given
- informed
- specific to procedure
- patient must have capacity

Capacity
- patient must be able to:
- understand the information, retain it, process the information and repeat it in their own words with reasoning.
- can not be assumed and is only valid for that episode
- should include risks, benefits, alternatives and consequences