Being accidentally stuck with a used needle is a scary situation that requires prompt action. If the needle has been in contact with someone else’s blood, there is a risk of contracting a serious bloodborne infection like HIV, hepatitis B, or hepatitis C. Knowing the right first steps to take can help reduce your risk of infection and get you the medical care you need.
Assess the Situation
The very first thing you should do after being stuck with a used needle is quickly assess the situation. Try to stay calm and evaluate:
- What part of your body was stuck?
- Was it a deep puncture or just a surface stick?
- What type of needle was it (e.g. hollow-bore needle, solid suture needle, etc.)?
- Was the needle visibly contaminated with blood?
Gathering these details helps you understand your level of risk and what actions to take next.
Let the Needle Stick Site Bleed
After a needlestick injury, you want to promote bleeding from the wound site. This helps flush out any germs or viruses that may have entered. Follow these steps:
- Wash your hands with soap and water.
- Allow the wound to bleed freely for a few minutes by gently squeezing around the site.
- Wash the area with soap and warm water.
- Do not suck on the wound or use caustic agents like bleach to clean it.
Prompting bleeding helps reduce the viral load if the needle contained infected blood. However, do not do anything that deliberately causes extreme bleeding.
Report the Incident
It is essential to promptly report the needlestick to the proper authorities, whether it occurred in a hospital setting or out in the community. This serves several purposes:
- It documents when and how the exposure occurred.
- Allows testing of the source patient if known.
- Initiates incident investigation and follow-up.
- Provides opportunity for immediate intervention and treatment.
In a healthcare facility, immediately notify your supervisor or the infection control office. Outside of healthcare, seek out whoever is responsible for the used needle and notify the local health department.
Seek Immediate Medical Care
After taking initial actions at the scene, you should go directly to a doctor, emergency room or urgent care clinic for further treatment. The key is getting care as soon as possible, ideally within 1-2 hours of exposure.
During medical evaluation, the doctor will assess your injury site, ask about the exposure circumstances, and may perform baseline blood tests. This visit also allows you to discuss post-exposure prophylaxis.
Post-Exposure Prophylaxis (PEP)
Post-exposure prophylaxis or PEP is short-term antiretroviral treatment started as soon as possible after exposure to HIV. PEP aims to prevent the virus from establishing infection. Research shows PEP can cut the risk of HIV infection by over 80% if begun within 72 hours.
PEP involves taking a 28-day course of antiretroviral drugs under the care of a doctor. Potential side effects include nausea, fatigue, and headaches. PEP should be considered after any needlestick involving blood from a person with possible or known HIV infection. It may also be offered after high-risk exposures even if the source is unknown.
Hepatitis B Vaccination
The doctor may also recommend vaccination against hepatitis B, if not already immune. The vaccine is highly effective at preventing hepatitis B infection if given shortly after exposure. The vaccine requires a series of 3 shots over 6 months for full protection.
Baseline Testing
Baseline blood tests for HIV, hepatitis B, and hepatitis C may be done during initial medical evaluation. Repeat testing is recommended over the coming weeks and months to look for any signs of new infection:
| HIV | Test at baseline, 6 weeks, 3 months, and 6 months |
| Hepatitis B | Test at baseline, 6 weeks, and 6 months |
| Hepatitis C | Test at baseline and 4-6 months |
If testing indicates you acquired HIV, hepatitis B, or hepatitis C from the needlestick, further treatment and clinical care options will be discussed.
Identify Source Patient
When a needlestick happens in a healthcare setting with a known source patient, that person should be informed of the incident and tested for HIV, hepatitis B, and hepatitis C if status is unknown. This helps determine your level of risk and need for prophylaxis.
Source patient testing requires consent as it involves their personal health information. However, most states mandate source patient testing after occupational exposures like needlesticks.
Follow Up as Recommended
In addition to your baseline medical evaluation, follow up appointments will be recommended over the coming months. This allows your healthcare provider to:
- Check that your injury site is healing properly
- Discuss any side effects from PEP or hepatitis vaccine
- Order recommended blood tests
- Provide counseling and address any health concerns
Sticking to the recommended follow up schedule is important for both your physical health and peace of mind.
Report any Symptoms
In the weeks to months following needlestick exposure, watch for any unusual symptoms and promptly report them to your doctor, including:
- Fever
- Chills
- Rash
- Swollen lymph nodes
- Fatigue
- Joint pain
- Loss of appetite
- Abdominal pain
Symptoms could indicate new infection with HIV, hepatitis B, or hepatitis C. Reporting any worrisome signs allows timely diagnosis and treatment.
Emotional Support
A needlestick injury can take not only a physical toll, but also a mental one. Feelings of anxiety, distress, anger, and fear are common after such an event. Express your emotions and seek support from loved ones. Counseling may also help cope with the stress.
Prevent Future Exposures
While not a first step, an important later action is reviewing how the needlestick happened and how to avoid another occurrence. This may involve:
- Using safer needle devices like retractable or sheathed needles
- Employing proper handling and disposal techniques
- Double-checking procedures
- Wearing personal protective equipment
- Increasing staff training on infection control practices
Learning from the incident promotes safety for yourself and others.
Conclusion
Accidental needlestick injuries require quick action to protect health. The first priorities after getting stuck by a used needle contaminated with blood are:
- Assess the injury site and details
- Promote bleeding while washing the area
- Report the incident promptly
- Seek immediate medical evaluation and possible PEP
- Arrange for source patient testing if known
By taking the right initial steps, you can minimize infection risk and get appropriate care to safeguard your health.