When dissolving medicines, accidently needle stick in the middle finger, what is the appropriate action?

PGIMER NO - 2020

Fundamental of Nursing

Easy

Appeared in: PGIMER NO - 2020

Explanation

The priority and correct first action after a needle stick injury is to wash the exposed area immediately and thoroughly with soap and running water.
This is a critical first aid step recommended by all major health organizations, including the WHO and CDC.
The mechanical action of washing helps to physically remove potential pathogens (like HIV, HBV, HCV) from the surface and inside the puncture wound, thereby reducing the risk of transmission.
The duration of washing is also important; while the option specifies 5 minutes, the key principle is immediate and thorough washing.

Option B: Using antiseptics like Betadine (povidone-iodine) is not the recommended initial step. Some guidelines advise against their use as they can cause tissue irritation and there is no evidence they provide additional benefit over soap and water.
Option C: Reporting the injury is a critical and mandatory step, but it is not the first action. Immediate first aid to the wound takes precedence over administrative or reporting tasks to minimize infection risk.
Option D: Squeezing the punctured finger is strictly contraindicated. This action can cause further trauma to the tissues and may increase systemic absorption of the pathogen by pushing it deeper into the bloodstream.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain First aid management of needle stick injury as background academic context rather than a clinical decision trigger.
Needle stick injuries are a significant occupational hazard for nurses, posing a risk of transmission of over 20 different blood-borne pathogens, including Hepatitis B (HBV), Hepatitis C (HCV), and HIV.
Following the correct protocol is crucial for patient safety (preventing cross-contamination) and the nurse's own health. All healthcare facilities have a clear post-exposure prophylaxis (PEP) protocol that must be initiated as soon as possible, ideally within 2 hours of exposure.
What if? If soap and water are not immediately available (e.g., in a field setting), the next best action is to use an alcohol-based hand rub or another antiseptic agent until proper washing is possible. However, washing remains the gold standard.

How to Approach the Question

First, identify the question type. This is a clinical scenario asking for the 'appropriate action', which means you need to prioritize interventions based on safety and established protocols.
Recall the standard first aid protocol for sharps injuries. The primary goal is to reduce the microbial load at the injury site immediately.
Evaluate each option based on this priority. Washing with soap and water is a direct, mechanical cleaning method.
Consider the other options. Squeezing is known to be harmful. Reporting is necessary but comes after immediate self-care. Using harsh antiseptics is not the recommended first step.
Select the option that represents the most immediate and effective safety action. In this case, washing the wound is the undisputed first priority.

Concept Tested & Keywords

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E6 Nursing Fundamentals Taylor p. 199-201

E6 Microbiology OneStop Sastry pp. 54-56, 55-57