Management of injury caused by a sharp object contaminated with blood or other body fluids outside health care settings

Abstract

Timely and proper management of injuries caused by a sharp object that has been contaminated with blood or other body fluids is important for preventing infections with blood-borne pathogens, such as hepatitis B and C viruses, and HIV. According to the literature, most of community-acquired injuries in adults are needle stick injuries related to home health care provided by qualified nurses; in children, most common are accidental stick injuries with discarded needles outside their residences. Management of such injuries requires a thorough risk assessment of transmissible microbes through the exposure to infected blood, based on the possible source of blood/body fluid on a contaminated object, the susceptibility of the injured person, the type of the injury and the circumstances in which the injury occurred. Measures that are implemented in accordance with the risk include: counseling, vaccination against hepatitis B, follow-up of the serum markers of the blood-borne viruses, and in rare cases administration of post-exposure prophylaxis for HIV or hepatitis-B-specific immunoglobulins as well as a prompt introduction of hepatitis C treatment in case of acute infection. The presented guidelines will serve as a basis for primary care physicians, epidemiologists, and infectologists for an appropriate management of sharp injuries outside health care settings.