Skip to main content
Erschienen in: European Journal of Trauma and Emergency Surgery 2/2014

01.04.2014 | Review Article

Best practice for needlestick injuries

verfasst von: S. Wicker, F. Walcher, S. Wutzler, C. Stephan, I. Marzi

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 2/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Needlestick injuries (NSIs) are a significant health hazard. Occupational transmission of bloodborne pathogens among healthcare workers (HCWs) is rare but has been repeatedly reported in the literature.

Methods

In October 2010, new regulations were introduced for medical aftercare of HCWs following NSIs at the University Hospital Frankfurt. In June 2013, a university hospital-wide early intervention program was introduced that gives HCWs immediate 24/7/365 access to an HIV postexposure prophylaxis kit after confirmed or probable occupational HIV exposure.

Results

Interdisciplinary collaboration between the attending surgeon and occupational health as well as infectious disease specialists facilitates optimal postexposure medical treatment of HCWs who suffer NSIs. Complete reporting of NSIs is a prerequisite for achieving optimal treatment of the affected HCWs.

Conclusion

An NSI is an emergency and needs to be evaluated immediately and, if necessary, treated as soon as possible. A standardized algorithm for initial diagnostic and treatment has proven to be helpful.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Gerberding JL. Occupational exposure to HIV in health care settings. N Engl J Med. 2003;348:826–33.PubMedCrossRef Gerberding JL. Occupational exposure to HIV in health care settings. N Engl J Med. 2003;348:826–33.PubMedCrossRef
2.
Zurück zum Zitat Henderson DK. Management of needlestick injuries: a house officer who has a needlestick. JAMA. 2012;307:75–84.PubMedCrossRef Henderson DK. Management of needlestick injuries: a house officer who has a needlestick. JAMA. 2012;307:75–84.PubMedCrossRef
3.
Zurück zum Zitat Beltrami EM, Kozak A, Williams IT, Saekhou AM, Kalish ML, Nainan OV, Stramer SL, Fucci M-CH, Frederickson D, Cardo DM. Transmission of HIV and hepatitis C virus from a nursing home patient to a health care worker. Am J Infect Control. 2003;31:168–75.PubMedCrossRef Beltrami EM, Kozak A, Williams IT, Saekhou AM, Kalish ML, Nainan OV, Stramer SL, Fucci M-CH, Frederickson D, Cardo DM. Transmission of HIV and hepatitis C virus from a nursing home patient to a health care worker. Am J Infect Control. 2003;31:168–75.PubMedCrossRef
4.
Zurück zum Zitat Kubitschke A, Bader C, Tillmann HL, Manns MP, Kuhn S, Wedemeyer H. Injuries from needles contaminated with hepatitis C virus: how high is the risk of seroconversion for medical personnel really? [Verletzungen mit Hepatitis C-Virus-kontaminierten Nadeln–Wie hoch ist das Risiko einer Serokonversion bei medizinischem Personal wirklich?] Internist. 2007;48:1165–72. Kubitschke A, Bader C, Tillmann HL, Manns MP, Kuhn S, Wedemeyer H. Injuries from needles contaminated with hepatitis C virus: how high is the risk of seroconversion for medical personnel really? [Verletzungen mit Hepatitis C-Virus-kontaminierten Nadeln–Wie hoch ist das Risiko einer Serokonversion bei medizinischem Personal wirklich?] Internist. 2007;48:1165–72.
6.
Zurück zum Zitat Himmelreich H, Sarrazin C, Stephan C, Rabenau HF, Marzi I, Wicker S. Early diagnosis of hepatitis C transmission after needlestick injury. [Frühzeitige Diagnose einer Hepatitis C-Übertragung nach Nadelstichverletzung.] Der Unfallchirurg. 2013;116(7):650–2. doi:10.1007/s00113-012-2261-5. Himmelreich H, Sarrazin C, Stephan C, Rabenau HF, Marzi I, Wicker S. Early diagnosis of hepatitis C transmission after needlestick injury. [Frühzeitige Diagnose einer Hepatitis C-Übertragung nach Nadelstichverletzung.] Der Unfallchirurg. 2013;116(7):650–2. doi:10.​1007/​s00113-012-2261-5.
8.
Zurück zum Zitat Holmberg SD, Spradling PR, Moorman AC, Denniston MM. Hepatitis C in the United States. N Engl J Med. 2013;368:1859–61.PubMedCrossRef Holmberg SD, Spradling PR, Moorman AC, Denniston MM. Hepatitis C in the United States. N Engl J Med. 2013;368:1859–61.PubMedCrossRef
9.
Zurück zum Zitat Green B, Griffiths EC. Psychiatric consequences of needlestick injury. Occup Med (Lond). 2013;63:183–8.CrossRef Green B, Griffiths EC. Psychiatric consequences of needlestick injury. Occup Med (Lond). 2013;63:183–8.CrossRef
10.
Zurück zum Zitat Naghavi SHR, Shabestari O, Alcolado J. Post-traumatic stress disorder in trainee doctors with previous needlestick injuries. Occup Med (Lond). 2013;63:260–5.CrossRef Naghavi SHR, Shabestari O, Alcolado J. Post-traumatic stress disorder in trainee doctors with previous needlestick injuries. Occup Med (Lond). 2013;63:260–5.CrossRef
11.
Zurück zum Zitat Wicker S, Gottschalk R, Spickhoff A, Rabenau HF. HIV testing after needlestick injury: must the index patient be informed? Dtsch Med Wochenschr. 2008;133:1517–20.PubMedCrossRef Wicker S, Gottschalk R, Spickhoff A, Rabenau HF. HIV testing after needlestick injury: must the index patient be informed? Dtsch Med Wochenschr. 2008;133:1517–20.PubMedCrossRef
12.
13.
Zurück zum Zitat Himmelreich H, Rabenau HF, Rindermann M, Stephan C, Bickel M, Marzi I, Wicker S. The management of needlestick injuries. Dtsch Arztebl Int. 2013;110:61–7.PubMedCentralPubMed Himmelreich H, Rabenau HF, Rindermann M, Stephan C, Bickel M, Marzi I, Wicker S. The management of needlestick injuries. Dtsch Arztebl Int. 2013;110:61–7.PubMedCentralPubMed
14.
Zurück zum Zitat Kuhar DT, Henderson DK, Struble KA, Heneine W, Thomas V, Cheever LW, Gomaa A, Panlilio AL for the US Public Health Service Working Group. Updated US public health service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013;34:875–92.PubMedCrossRef Kuhar DT, Henderson DK, Struble KA, Heneine W, Thomas V, Cheever LW, Gomaa A, Panlilio AL for the US Public Health Service Working Group. Updated US public health service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013;34:875–92.PubMedCrossRef
15.
Zurück zum Zitat Deutsche AIDS-Gesellschaft, Österreichische AIDS-Gesellschaft. German–Austrian recommendations for post-exposure prophylaxis of HIV infection. [Postexpostitionelle Prophylaxe der HIV-Infektion Deutsch-Österreichische Empfehlungen.] Dtsch Med Wochenschr. 2009;134:16–33. Deutsche AIDS-Gesellschaft, Österreichische AIDS-Gesellschaft. German–Austrian recommendations for post-exposure prophylaxis of HIV infection. [Postexpostitionelle Prophylaxe der HIV-Infektion Deutsch-Österreichische Empfehlungen.] Dtsch Med Wochenschr. 2009;134:16–33.
16.
Zurück zum Zitat German Standing Committee on Vaccination (STIKO). Recommendation of the German Standing Committee on Vaccination at the Robert Koch-Institute. [Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut.] Epidemiologisches. Bulletin. 2013;34:313–44. German Standing Committee on Vaccination (STIKO). Recommendation of the German Standing Committee on Vaccination at the Robert Koch-Institute. [Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut.] Epidemiologisches. Bulletin. 2013;34:313–44.
17.
Zurück zum Zitat Sarrazin C, Berg T, Ross RS, et al. Prophylaxis, diagnosis and therapy of hepatitis C virus (HCV) infection: the German guidelines on management of HCV infection. Z Gastroenterol. 2010;48:289–351.PubMedCrossRef Sarrazin C, Berg T, Ross RS, et al. Prophylaxis, diagnosis and therapy of hepatitis C virus (HCV) infection: the German guidelines on management of HCV infection. Z Gastroenterol. 2010;48:289–351.PubMedCrossRef
18.
Zurück zum Zitat Brum MCB, Filho FFD, Yates ZB, Viana MCV, Chaves EBM, Trindade DM. HIV seroconversion in a health care worker who underwent postexposure prophylaxis following needlestick injury. Am J Infect Control. 2013;41:471–2.CrossRef Brum MCB, Filho FFD, Yates ZB, Viana MCV, Chaves EBM, Trindade DM. HIV seroconversion in a health care worker who underwent postexposure prophylaxis following needlestick injury. Am J Infect Control. 2013;41:471–2.CrossRef
19.
Zurück zum Zitat Camacho-Ortiz A. Failure of HIV postexposure prophylaxis after a work-related needlestick injury. Infect Control Hosp Epidemiol. 2012;33:646–7.PubMedCrossRef Camacho-Ortiz A. Failure of HIV postexposure prophylaxis after a work-related needlestick injury. Infect Control Hosp Epidemiol. 2012;33:646–7.PubMedCrossRef
20.
Zurück zum Zitat Beltrami EM, Luo CC, de la Torre N, Cardo DM. Transmission of drug-resistant HIV after occupational exposure despite postexposure prophylaxis with a combination drug regime. Infect Control Hosp Epidemiol. 2002;23:345–8.PubMedCrossRef Beltrami EM, Luo CC, de la Torre N, Cardo DM. Transmission of drug-resistant HIV after occupational exposure despite postexposure prophylaxis with a combination drug regime. Infect Control Hosp Epidemiol. 2002;23:345–8.PubMedCrossRef
21.
Zurück zum Zitat Cardo D, Culver DH, Ciesielski CA, Srivastava PU, Marcus R, Abiteboul D, Heptonstall J, Ippolito G, Lot F, McKibben PS, Bell DM. Case-control study of HIV seroconversion in health care workers after percutaneous exposure. N Engl J Med. 1997;337:1485–90.PubMedCrossRef Cardo D, Culver DH, Ciesielski CA, Srivastava PU, Marcus R, Abiteboul D, Heptonstall J, Ippolito G, Lot F, McKibben PS, Bell DM. Case-control study of HIV seroconversion in health care workers after percutaneous exposure. N Engl J Med. 1997;337:1485–90.PubMedCrossRef
22.
Zurück zum Zitat Wicker S, Walcher F, Wutzler S, Marzi I, Stephan C. HIV-Prophylaxis-Kits: a concept for emergency treatment in the context of postexposure prophylaxis. Chirurg. 2013; in press. Wicker S, Walcher F, Wutzler S, Marzi I, Stephan C. HIV-Prophylaxis-Kits: a concept for emergency treatment in the context of postexposure prophylaxis. Chirurg. 2013; in press.
23.
Zurück zum Zitat Marcus U, Stellbrink HJ. New guidelines for postexposure prophylaxis. [Neue Leitlinie zur Postexpositionsprophylaxe.] HIV & More. 2013; 3:30–5. Marcus U, Stellbrink HJ. New guidelines for postexposure prophylaxis. [Neue Leitlinie zur Postexpositionsprophylaxe.] HIV & More. 2013; 3:30–5.
Metadaten
Titel
Best practice for needlestick injuries
verfasst von
S. Wicker
F. Walcher
S. Wutzler
C. Stephan
I. Marzi
Publikationsdatum
01.04.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 2/2014
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-014-0376-9

Weitere Artikel der Ausgabe 2/2014

European Journal of Trauma and Emergency Surgery 2/2014 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.