Needlestick injury
A needlestick injury is a percutaneous puncture from a contaminated sharp (hypodermic needle, cannula, suture needle, scalpel or other device) that may expose an individual to another person’s blood or body fluids.
These injuries occur in healthcare settings (occupational exposures) and in the community (discarded sharps, shared injecting equipment). In emergency medicine the priorities are prompt first aid, rapid risk assessment, immediate initiation of any time‑sensitive prophylaxis, and arranged follow‑up.
Where not otherwise stated, align actions with national guidance (NICE CG139; RCEM position statement), the Green Book (Hepatitis B/HBIG) and EAGA/GOV.UK HIV PEP guidance.
Why this matters
- Major transmission risks are bloodborne viruses: hepatitis B (HBV), hepatitis C (HCV) and HIV. Relative per‑exposure risks (approximate, UK):
- HBV (susceptible recipient): up to 1 in 3.
- HCV: approximately 1 in 30.
- HIV: approximately 1 in 300.
- Timely decisions matter: hepatitis B vaccine and HBIG, and HIV PEP are time‑sensitive; HCV has no PEP and relies on testing and early antiviral treatment if infection occurs.
Epidemiology (UK highlights)
- Prevalence estimates: HBV < 1%, HCV < 0.5%, HIV < 0.3%.
- Surveillance (1997-2018): documented HCV seroconversions after hollow‑bore injuries; very rare HIV seroconversion in UK healthcare workers; HBV seroconversions are uncommon, reflecting vaccination programmes.