What to Do Following a Sharps Injury
Step 1: Provide immediate care to the exposure site
- Wash wounds and skin with soap and water.
- Flush mucous membranes with water.
Step 2: Evaluate the exposure
- Determine risk associated with exposure.
|Exposures posing risk of infection
||Substances posing risk of infection transmission
Step 3: Give post-exposure prophylaxis (PEP) for exposures posing risk of infection transmission
- HBV - view treatment table
- Give PEP as soon as possible, preferably within 24 hours.
- PEP can be given to pregnant women.
- HCV - PEP not recommended
- HIV - view treatment table
- Initate PEP within hours of exposure.
- Offer pregnancy testing to all women of childbearing age even if they are not known to be pregnant.
- Seek expert consultation if viral resistance is suspected.
- Administer PEP for 4 weeks if tolerated.
Step 4: Perform follow-up testing and provide counseling
- HBV exposures
- Test for anti-HB 1 to 2 months after the last dose of the vaccine if only a vaccine is given.
- Follow-up is not indicated if the exposed person is immune to HBV or has received HBIG PEP.
- HCV exposures
- Perform testing for anti-HCV and ALT 4 to 6 months after exposure.
- Perform HCV RNA testing at 4 to 6 weeks if an earlier diagnosis of HCV infection is desired.
- Confirm repeatedly reactive anti-HCV EIAs with supplemental tests.
- HIV exposures
- Evaluate exposed persons taking PEP within 72 hours after exposure and monitor them for drug toxicity for at least 2 weeks.
- Perform HIV antibody testing for at least 6 months post-exposure (e.g., at baselines of 6 weeks, 3 months, and 6 months).
- Perform HIV antibody testing for illness compatible with an acute retroviral syndrome.
- Advise exposed persons to use precautions to prevent secondary transmission during the follow-up period.
- National Institute for Occupational Safety and Health (NIOSH)
- Centers for Disease Control and Prevention
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