STOP STICKS CAMPAIGN

Sharps Injuries: 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.

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.