What is a needlestick injury or blood/body fluid exposure?
An injury involving exposure to blood or other human material is known as a blood and body fluid exposure (BBFE) injury, or needlestick injury. Health care workers must take immediate action if they sustain such injuries.
BBFE puts a healthcare worker at risk of infection from blood borne viruses such as HIV, Hepatitis B virus (HBV) and Hepatitis C virus (HCV).
It is very important that BBFEs are managed correctly. Healthcare workers must be aware of, and have training in, BBFE procedures.
Download Immediate Management of BBFE Pack
The pack includes response procedures, laboratory test request forms and information sheets for the source (ie. patient) and exposed (ie. injured) persons.
What to do in the event of a BBFE?
Step 1: Apply First Aid
- Immediately rinse the affected area under running warm water for at least 3 minutes
- Gently squeeze the puncture wound to flush out contamination
- Paint puncture wound with povidone-iodine (Betadine) or isopropyl alcohol
- Cover with a dry, water proof dressing
Step 2: Notify a Doctor
Notify a medical practitioner to arrange specimen collection.
The doctor may also choose to contact a hospital clinical microbiologist, clinical immunologist or infectious diseases physician and, in consultation with them, may decide that post-exposure prophylaxis is needed.
Prophylaxis should be administered within hours of exposure. It is used to reduce the risk of disease, and prompt reporting of needlestick blood or body fluid exposure is important to diagnosing appropriate management measures.
Step 3: Collect Source Person & Exposed Person Blood Specimens
- Inform patient (source) of exposure and give them the patient information sheet in the BBFE pack. (Note the guidelines for getting consent for testing source blood)
- Take source person and exposed person bloods using SST (yellow top) tubes. (Testing can also be performed using EDTA, heparin, sodium citrate, ACD or CPD tubes)
- Label the bloods correctly
- Fill out the source person and exposed person forms in the BBFE pack. On the forms, record the name of the general practitioner you notified.The exposed and source forms must also indicate the contact phone numbers of the exposed and source and who the results are to go to i.e. specified general practitioner, workplace occupational health or infection control supervisor, manager
- Place blood tubes in specimen bags with forms
- The source person can now leave
Step 4: Send the Completed Forms and Bloods to the Lab Urgently
- Contact the laboratory on (04) 381 5900 to arrange an urgent courier collection between 7am-6.30pm
- Outside of these hours, phone (04) 381 5900 and choose Option 1 to speak with laboratory staff
- Send source person and exposed person specimens with blood test forms to the laboratory. A taxi may need to be arranged if outside of usual courier run hours.
- Remember to provide both specimens’ identity details
Step 5: Follow Up Testing on Exposed Person
- The laboratory will contact the person managing the results. This person is reponsible to ensure results are communicated and may have to arrange prophylaxis for the exposed person.
- Follow-up blood test forms are provided in the MANAGEMENT OF BBFE information pack above. Follow-up testing is only required when the source blood is positive, or if the source is unknown.