Critical Care Medicine-Infections and Immunologic Disease>>>>>Hospital Infection Control, Hospital Acquired Infections
Question 2#

You are placing a central venous catheter in a 44-year-old patient with unknown identity found down in the street. The patient is intubated and sedated. After multiple attempts to cannulate the vein, you accidentally stick your finger with the finder needle. You remove your glove and see that your finger is bleeding.

What should you do next? 

A. Wash your finger with soap and water for 2 minutes, then call your hospital’s infection control, infectious diseases consult, or emergency medicine needlestick response team for further assistance
B. Wash your finger with soap and water for 2 minutes, then order testing for HIV, hepatitis B, and hepatitis C to be sent from the patient’s blood
C. Clean your finger thoroughly with a chlorhexidine swab and then wash with soap and water for 2 minutes
D. Bandage your finger with an antibiotic ointment and then call your hospital’s infection control, infectious diseases consult, or emergency medicine needlestick response team for further assistance

Correct Answer is A

Comment:

Correct Answer: A

Soap and water should be used to wash the injured body part after a needlestick injury. The efficacy of chlorhexidine cleansing is not known. The patient on whom the procedure was being performed should be tested for HIV and hepatitis, but only after consent has been obtained from the patient. Because this patient is intubated and sedated, consent for testing cannot currently be obtained, and it is important to discuss postexposure prophylaxis against transmissible infections with your hospital’s needlestick team as soon as possible after a needlestick or mucosal exposure occurs.

References:

1. Rizk C, Monroe H, Orengo I, Rosen T. Needlestick and sharps injuries in dermatologic surgery: a review of preventative techniques and postexposure protocols. J Clin Aesthet Dermatol. 2016;9:41-49.
2. Riddell A, Kennedy I, Tong CY. Management of sharps injuries in the healthcare setting. BMJ. 2015;351:h3733.