Managing injuries and exposure

Studies have shown that cleaning a wound with an antiseptic or squeezing it does not reduce the risk of infection. In addition, do not use caustic agents, such as bleach, on injuries from sharp objects.

If you are accidentally exposed to blood or other body fluids, either by a needlestick, an injury from another sharp object, or a splash of fluid:

• Wash the needlestick or cut with soap and water.
• Flush splashes to the nose, mouth, or skin with water.
• Irrigate splashes to the eyes with water or saline.

Postexposure prophylaxis

Detailed protocols for the administration of postexposure prophylaxis are beyond the scope of this course. If you, a coworker, or a client has been exposed to blood or other body fluids, consult an infectious disease specialist familiar with postexposure prophylaxis.

Postexposure prophylaxis with drugs or other therapy can reduce the risk of transmission of some bloodborne pathogens. Whether postexposure prophylaxis is indicated following exposure to blood or other body fluids depends on a number of factors, including the infection status of the client whose blood or fluids are involved, the type of exposure (a splash to the skin versus a deep puncture wound), whether or not the exposed person has been vaccinated against hepatitis B, how much time has passed since the exposure, and the availability of needed drugs or other therapy.

Some therapies include:

• For hepatitis B: Hepatitis B immune globulin and hepatitis B vaccine can reduce the risk of infection after exposure to blood or other body fluids containing the hepatitis B virus.
• For HIV: Several antiretroviral drugs, used either alone or in combination, have been recommended to reduce the risk of HIV transmission following accidental exposure in health care workers. These include zidovudine (AZT, Retrovir), lamivudine (3TC, Epivir), indinavir (Crixivan), and nelfinavir (Viracept).
• For hepatitis C: There is no postexposure prophylaxis available for hepatitis C. Neither immune globulin nor antiviral drugs have been shown to reduce the risk of hepatitis C transmission.

All staff who are at risk of exposure to blood or other body fluids should be vaccinated against the hepatitis B virus.

 

©2004 EngenderHealth