Sharp Safety and Exposure

A sharps injury is a percutaneous wound caused by a needle or another sharp object. The concern is not the size of the puncture; it is the possibility that contaminated blood has been carried through the skin. Hollow-bore needles are especially hazardous because their lumen can retain blood and deposit it into tissue. Blood-borne pathogens of concern include hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Exposure can also occur when blood contacts the eyes, mouth, or non-intact skin. A glove reduces contamination but does not make a puncture harmless, and a wound that does not bleed visibly can still be clinically significant. An experienced nurse begins with the mechanism rather than the appearance of the injury. Clarify whether the sharp was hollow-bore, whether it had been used, whether blood was visible, how deep the injury was, and whether the needle had been in a blood vessel. Identify the source patient when possible and check the worker's hepatitis B vaccination and immunity records. These details determine urgency and the post-exposure pathway. The injury is a...