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Needlestick is a topic covered in the 5-Minute Emergency Consult.

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  • Mechanisms of exposure to blood or body fluid:
    • Percutaneous
    • Mucous membrane
    • Skin
  • General prevention:
    • Universal precautions
    • Avoid recapping of needles
    • Wear gloves: Decreases amount of blood exposure by 50%
    • Double gloving
    • Follow body–substance isolation protocols.
    • Hepatitis B virus vaccination
  • Risk factors:
    • Risk of seroconversion from a single needlestick exposure without prior immunization:
      • Hepatitis B virus: 37–62% from HBsAg-positive and HBeAg-positive source, 23–37% from HBsAg-positive and HBeAg-negative source
      • Hepatitis C virus: 1.8%
      • HIV: Blood 0.3%, mucous membrane 0.09%
    • Infectiousness of various body fluids for HIV:
      • Plasma/serum: 10–5,000 ppm
      • CSF: 10–1,000 ppm
      • Semen: 10–50 ppm
      • Vaginal secretions, urine, saliva, tears, breast milk: <1 ppm
    • Factors affecting risk:
      • Viral load
      • Actual injection volume
      • Type and size of needle
      • Portal of entry (depth of inoculation)
      • Duration of contact
      • Level of disease in source patient
      • Host susceptibility
      • Barriers (e.g., through gloves)

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Rosen, Peter, et al., editors. "Needlestick." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307699/2.3/Needlestick.
Needlestick. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307699/2.3/Needlestick. Accessed June 18, 2019.
Needlestick. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307699/2.3/Needlestick
Needlestick [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 June 18]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307699/2.3/Needlestick.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Needlestick ID - 307699 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307699/2.3/Needlestick PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -