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Needle-stick Guideline Workup

  • Author: Brenda Cosens, RN; Chief Editor: Rick Kulkarni, MD  more...
 
Updated: May 11, 2014
 

Laboratory Studies

See the list below:

  • Source patient (if available)
    • HIV
    • Hepatitis B antigen
    • Hepatitis C antibody
    • Aspartate aminotransferase/alanine aminotransferase (AST/ALT) and alkaline phosphatase levels
  • Victim/health care worker
    • Hepatitis B surface antibody
    • HIV
    • Hepatitis C antibody testing at 2 weeks, 4 weeks, and 8 weeks
  • Prior to initiating retrovirals
    • Pregnancy test (stat)
    • CBC count with differential and platelets
    • Serum creatinine/BUN levels
    • Urinalysis with microscopic analysis
    • AST/ALT levels
    • Alkaline phosphatase level
    • Total bilirubin level
 
 
Contributor Information and Disclosures
Author

Brenda Cosens, RN Branch Director, Encompass Home Health

Disclosure: Nothing to disclose.

Coauthor(s)

Robert E Suter, DO, MHA Professor, Division of Emergency Medicine, University of Texas at Southwestern Medical School

Robert E Suter, DO, MHA is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Eric L Weiss, MD, DTM&H Medical Director, Office of Service Continuity and Disaster Planning, Fellowship Director, Stanford University Medical Center Disaster Medicine Fellowship, Chairman, SUMC and LPCH Bioterrorism and Emergency Preparedness Task Force, Clinical Associate Professor, Department of Surgery (Emergency Medicine), Stanford University Medical Center

Eric L Weiss, MD, DTM&H is a member of the following medical societies: American College of Emergency Physicians, American College of Occupational and Environmental Medicine, American Medical Association, American Society of Tropical Medicine and Hygiene, Physicians for Social Responsibility, Southeastern Surgical Congress, Southern Oncology Association of Practices, Southern Clinical Neurological Society, Wilderness Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD Attending Physician, Department of Emergency Medicine, Cambridge Health Alliance, Division of Emergency Medicine, Harvard Medical School

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, Society for Academic Emergency Medicine

Disclosure: Received salary from WebMD for employment.

Additional Contributors

William G Gossman, MD, FAAEM Associate Clinical Professor of Emergency Medicine, Creighton University School of Medicine; Chairman, Department of Emergency Medicine, Creighton University Medical Center

William G Gossman, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

References
  1. Bassett IV, Freedberg KA, Walensky RP. Two drugs or three? Balancing efficacy, toxicity, and resistance in postexposure prophylaxis for occupational exposure to HIV. Clin Infect Dis. 2004 Aug 1. 39(3):395-401. [Medline].

  2. CDC. Recommendations for follow-up of health-care workers after occupational exposure to hepatitis C virus. MMWR Morb Mortal Wkly Rep. 1997 Jul 4. 46(26):603-6. [Medline].

  3. Merchant RC, Keshavarz R. HIV postexposure prophylaxis practices by US ED practitioners. Am J Emerg Med. Jul 2003. 21(4):309-12. [Medline].

  4. Henderson DK. Management of needlestick injuries: a house officer who has a needlestick. JAMA. 2012 Jan 4. 307(1):75-84. [Medline].

  5. Cardo DM, Culver DH, Ciesielski CA, et al. A case-control study of HIV seroconversion in health care workers after percutaneous exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group. N Engl J Med. 1997 Nov 20. 337(21):1485-90. [Medline].

  6. CDC. Public Health Service guidelines for the management of health-care worker exposures to HIV and recommendations for postexposure prophylaxis. Centers for Disease Control and Prevention. MMWR Recomm Rep. 1998 May 15. 47(RR-7):1-33. [Medline].

  7. Laramie AK, Pun VC, Fang SC, Kriebel D, Davis L. Sharps injuries among employees of acute care hospitals in Massachusetts, 2002-2007. Infect Control Hosp Epidemiol. 2011 Jun. 32(6):538-44. [Medline].

  8. Butsashvili M, Kamkamidze G, Kajaia M, Kandelaki G, Zhorzholadze N. Circumstances surrounding the community needle-stick injuries in Georgia. J Community Health. 2011 Dec. 36(6):1050-2. [Medline].

  9. Sidwell RU, Green JS, Novelli V. Management of occupational exposure to HIV--what actually happens. Commun Dis Public Health. 1999 Dec. 2(4):287-90. [Medline]. [Full Text].

  10. Houston SH, Sinnott JT, Palumbo SJ. Employee health and safety. Reese, ed. Practical Approach to Infectious Diseases. 1996. 706-724, 1406-1409.

  11. CDC. Recommendations for Postexposure Interventions to Prevent Infections with Hepatitis B Virus, Hepatitis C Virus, or Human Immunodeficiency Virus, and Tetanus in Persons Wounded During Bombings or Similar Mass-Casualty Events - United States, 2008. MMWR. August 2008. 57(RR-6):1-19. [Full Text].

  12. Hsieh WB, Chiu NC, Lee CM, Huang FY. Occupational blood and infectious body fluid exposures in a teaching hospital: a three-year review. J Microbiol Immunol Infect. Aug 2006. (4):321-7. [Medline].

  13. Merchant RC, Becker BM, Mayer KH, Fuerch J, Schreck B. Emergency department blood or body fluid exposure evaluations and HIV postexposure prophylaxis usage. Acad Emerg Med. Dec 2003. 10(12):1345-53. [Medline].

  14. Moran GJ. Emergency department management of blood and body fluid exposures. Ann Emerg Med. 2000 Jan. 35(1):47-62. [Medline].

  15. Peate I. Occupational exposure of staff to HIV and prophylaxis therapy. Br J Nurs. 2004 Oct 28-Nov 10. 13(19):1146-50. [Medline].

  16. Rinnert KJ. A review of infection control practices, risk reduction, and legislative regulations for blood-borne disease: applications for emergency medical services. Prehosp Emerg Care. 1998 Jan-Mar. 2(1):70-5. [Medline].

  17. Schriger DL, Mikulich VJ, Centers for Disease Control and Prevention. The management of occupational exposures to blood and body fluids: revised guidelines and new methods of implementation. Ann Emerg Med. 2002 Mar. 39(3):319-21. [Medline].

  18. U.S. Public Health Service. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis. MMWR Recomm Rep. 2001 Jun 29. 50(RR-11):1-52. [Medline]. [Full Text].

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