What will you do if you have a needle stick injury from an HIV patient?

Appeared in: NORCET 1 - 2020

Explanation

Washing the injury with soap and running water is the immediate, standard first-aid protocol for any percutaneous exposure.
This action helps to mechanically remove contaminants and reduce the viral load on the surface of the wound.
It is a gentle method that avoids causing further tissue damage, which could potentially increase the absorption of the virus.

Option A: Making an incision causes further tissue damage, increases bleeding, and can facilitate the entry of the virus deeper into the bloodstream, increasing the risk of infection.
Option B: Sucking the wound introduces the pathogen to the mucous membranes of the mouth. This creates a new and significant route for potential transmission and is strongly discouraged.
Option C: Squeezing or 'milking' the wound can cause micro-trauma to the surrounding tissues. This damage may disrupt local blood vessels and potentially enhance the absorption of the virus into the circulation.

Clinical Relevance

Nursing practice connection: Use the key finding related to First aid for needlestick injury to guide bedside assessment, documentation, and the next nursing action.
Immediate and correct first aid is the critical first step in the post-exposure prophylaxis (PEP) cascade, potentially reducing the risk of seroconversion.
Nurses must know to immediately report the injury to their supervisor to initiate the facility's exposure protocol, which includes risk assessment and timely administration of PEP, ideally within 2 hours.
What if the exposure was a splash of blood to the eyes? The correct action would be to immediately irrigate the eyes with copious amounts of water or normal saline for several minutes, while keeping the eyes open. Do not rub the eyes.

How to Approach the Question

First, identify the clinical event described in the question: a high-risk occupational exposure (a needlestick injury from an HIV-positive patient).
Next, recall the standard first-aid protocol for such an injury. The primary goal is to clean the area safely without causing more harm or increasing risk.
Evaluate each option against this principle. Actions that cause further trauma (incision, squeezing) or create new exposure routes (sucking) are incorrect and dangerous.
Eliminate the harmful options: giving an incision, sucking the blood, and squeezing the blood are all contraindicated.
Select the option that represents the correct, non-harmful, and recommended first step: washing the area with soap and water.

Concept Tested & Keywords

QDadX5bNrnI9DmEdp6uVXU

E6 Medicine Harrison 22e Part 1 p. 1666-1668

E6 Microbiology OneStop Sastry p. 55-57

Practise the full NORCET 1 - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.