sharps injuries

Question 1

what are the blood borne viruses?

Answer 1

hep B
hep C
HIV

Question 2

what is a sharp injury?

Answer 2

needles/sharp objects contaminated w/ blood/bodily fluids that pierce/break the skin
splashing of blood/bodily fluids onto broken skin
contamination of eyes, nose or mouth with blood/bodily fluids
human bite that breaks the skin

Question 3

what are the bodily fluids?

Answer 3

blood
saliva
semen/vaginal secretions
cerebrospinal fluid
synovial fluid
pleural fluid
peritoneal fluid
pericardial fluid
amniotic fluid

Question 4

what is a significant exposure?

Answer 4

sharps injury/exposures involving source px infected w/ blood borne virus

Question 5

what are some common dental injuries?

Answer 5

IDB needle in thumb
CoCr dentures outwith mouth
burs/ultrasonic tips left in tisu in handpieces at elbow height
slipping luxators
anaesthetic spraying from palate
unsheathed needles on messy trays

Question 6

what is the probability of acquiring HBV after injury?

Answer 6

30%

Question 7

what is the probability of acquiring HCV after injury?

Answer 7

3%

Question 8

what is the probability of acquiring HIV after injury?

Answer 8

0.3%

Question 9

how are sharps injuries prevented?

Answer 9

hand hygiene
PPE
safe disposal of waste
minimal manipulation of sharps
safer sharps
instruments over fingers for suturing
blunt-tip suture needles

Question 10

what to do after sharps injury? (AWARE)

Answer 10

apply pressure and allow bleeding
-squeeze injury
wash don't scrub
assess type of injury
risk of source blood
establish contact

Question 11

how do you assess the type of injury?

Answer 11

deep
penetrating by a device visibly contaminated with blood
injury with decive previously been placed directly in source px artery/verin
solid instrument/hollow bore needle

Question 12

how do you assess the risk of source blood?

Answer 12

exposure to source px with end stage HIV/pos for HCV RNA
known to have HIV/AIDS or hep B infection
high risk group eg iv drug user

Question 13

how would you establish contact?

Answer 13

report injury promptly to senior staff
call occupational health
interview source px/consent for bloods
record injury
follow up prophylaxis, counselling and prevention

Question 14

why are baseline bloods from source px and HCW taken?

Answer 14

in px neg, reassurance to HCW
check HCW baseline HBV antibody status
baseline for HCV and HIV for HCW

Question 15

what is the post exposure prophylaxis for HBV?

Answer 15

not required for successful vaccinated
hep B immune globulin (HBIG)
-70-75% protection
unvaccinated- HBIG 1 and vaccine
non responder HBIG and booster
asap within 72 hours

Question 16

what is the post exposure prophylaxis for HIV?

Answer 16

anti-retroviral
PEP asap- w/i hours
common side effects- headaches, fever, nausea
side effects difficult

Question 17

when is the follow up?

Answer 17

12 weeks

-high confidence of freedon from infection

Question 18

what are exposure prone procedures?

Answer 18

invasive procedures where there is a high risk that injury to the worker may result in the exposure of px open tissues to blood of worker

Question 19

describe an exposure prone procedure

Answer 19

workers gloved hand in contact w/ sharp instruments, needle tips or sharp tissues inside open body cavity, wound or anatomical space where hand/fingertips not visible at all times