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Needlestick Injuries (Needlestick Injury)

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Penetrating stab wounds caused by needles. They are of special concern to health care workers since such injuries put them at risk for developing infectious disease.

Also Known As:

Needlestick Injury; Injuries, Needlestick; Needle-Stick Injuries; Needle-Sticks; Needlesticks; Injuries, Needle-Stick; Injuries, Sharps; Injury, Needle-Stick; Injury, Needlestick; Injury, Sharps; Needle Stick Injuries; Needle Sticks; Needle-Stick; Needle-Stick Injury; Needlestick; Sharps Injury; Sharps Injuries

Networked: 446 relevant articles (23 outcomes, 36 trials/studies)

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Disease Context: Research Results

Wounds and Injuries: 94065
- Penetrating Wounds: 162
  - Stab Wounds: 442
    - Needlestick Injuries: 446

Related Diseases

1.	Pain (Aches)
2.	Infection
3.	Wounds and Injuries (Trauma)
4.	Ebola Hemorrhagic Fever
5.	Hyperalgesia

Experts

1.	Lavoie, Marie-Claude: 3 articles (01/2014 - 05/2010)
2.	Gasthaus, Klaus: 3 articles (12/2013 - 01/2009)
3.	Wittmann, Andreas: 3 articles (12/2013 - 01/2009)
4.	Köver, Jan: 3 articles (12/2013 - 01/2009)
5.	Kralj, Nenad: 3 articles (12/2013 - 01/2009)
6.	Hofmann, Friedrich: 3 articles (12/2013 - 01/2009)
7.	Patrician, Patricia A: 3 articles (12/2012 - 12/2010)
8.	Loan, Lori: 3 articles (12/2012 - 12/2010)
9.	Slifer, Keith J: 3 articles (08/2011 - 01/2002)
10.	Andersson, Lars: 3 articles (02/2008 - 01/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Needlestick Injuries:

1.	InterferonsIBA 01/01/2003 - "We carried out this study to assess the risk of hepatitis C virus (HCV) transmission after needlestick injuries in medical personnel, and to evaluate the efficacy of short-duration interferon administration to prevent HCV transmission. " 01/01/2003 - "Risk of HCV transmission after needlestick injury, and the efficacy of short-duration interferon administration to prevent HCV transmission to medical personnel." 10/01/2000 - "Hepatitis C virus (HCV) was successfully eradicated by a short course of interferon (IFN) therapy in a nurse with acute HCV infection from a needlestick accident. " 09/01/1995 - "The present report is of a case of acute hepatitis C that developed after a needlestick injury, despite short duration interferon treatment performed just after the accident in a trial effort to prevent HCV transmission. " 05/01/1997 - "Early therapy with interferon for acute hepatitis C acquired through a needlestick."
2.	Hepatitis B Vaccines (Hepatitis B Vaccine)IBA 01/01/2012 - "Only 5(10.4%) of workers with needle stick injury had completed three doses of Hepatitis B vaccine. " 09/01/1996 - "In conclusion, a significant number of surgeons appeared not to have completed a course of hepatitis B vaccine in the presence of a high frequency of 'sharps' injuries. " 01/01/1988 - "EMS personnel require early and continuing educational efforts directed toward prevention of needlestick injuries and should be offered hepatitis B vaccine." 10/01/1998 - "Preclinical students knew more than clinical students about the efficacy of hepatitis B vaccine, use of antiretroviral therapy after occupational exposure to human immunodeficiency virus, and nonvaccinated healthcare workers' risk of infection from needlestick injuries (P<.001). " 09/16/1991 - "With consistent application of a stringent postexposure protocol, and wide acceptance of the hepatitis B vaccine, we have had no sharps injury-related infections during the past 3 years. "
3.	RNA (Ribonucleic Acid)IBA 01/01/2002 - "In one of the exposed subjects, a nurse, the result of the PCR test for HCV RNA was positive at 2 wk after the needlestick incident; the nurse's viral load was very low (800 copies/ml) and she responded well to immediate medical treatment. " 11/01/1992 - "In our study, the risk of hepatitis C virus transmission from a single needlestick accident with hepatitis C virus RNA-positive blood was 10%, considerably higher than the 4% estimated in a previous study. " 05/01/2013 - "Two subjects (0.31%) had anti-HCV and HCV-RNA seroconversion with an overall incidence of 2.04/1000 person-years and a 4.8% incidence among the 21 subjects who reported a needle-stick injury. " 03/01/2009 - "Late appearance of hepatitis C virus RNA after needlestick injury: necessity for a more intensive follow-up." 12/01/2003 - "A physician with a positive hepatitis C virus RNA test after a needlestick injury."
4.	Lidocaine (Xylocaine)FDA LinkGeneric 07/01/2005 - "The percent of the unconditioned reflex amplitude for reflex activation history and the maximum H-reflex were decreased at 25 and 45 min post effusion as compared to measures taken at baseline, post needle stick, and post lidocaine (P<0.05). " 12/01/2004 - "Pre- and post-synaptic spinal mechanisms were measured at baseline, immediately following a needle stick, immediately following a Xylocaine injection, and 25 and 45 min post-saline injection. " 12/01/2003 - "Steps modified to allow easier implantation of Durasphere beads include a single needle stick at the 4 o'clock position, hydrodissection with 1.5 ml 1% lidocaine into the submucosa, gradual withdrawal/advancement or rotation of the needle tip after resistance is noted and holding the needle in position for an additional 10 seconds after proper coaptation is achieved to prevent the beads from leaking out of the needle puncture site. " 01/01/2008 - "The aims of this study were to compare the topical anesthetic effect of two different preparations of lidocaine/prilocaine, cream versus thermosetting gel, on the reduction of pain from needle stick in the palate. " 03/01/2001 - "More wounds treated with LET were anesthetic to a needlestick than wounds treated with EMLA (73% vs 40%, p = 0.01); however, there was no between-group difference in the median pain of lidocaine infiltration (LET-12 mm vs EMLA-13 mm, p = 0.89). "
5.	Prilocaine (Citanest)FDA LinkGeneric 01/01/2008 - "The aims of this study were to compare the topical anesthetic effect of two different preparations of lidocaine/prilocaine, cream versus thermosetting gel, on the reduction of pain from needle stick in the palate. " 06/01/2009 - "A eutectic mixture of lidocaine and prilocaine (EMLA) has been shown to be effective in reducing pain from needle sticks, including those associated with blood sampling and intravenous insertion. " 02/01/2008 - "Topical anesthetics based on a combination of 2.5% lidocaine and 2.5% prilocaine are efficient in eliminating pain from needle stick when placed on skin and oral mucosa. " 01/01/2008 - "Reducing pain from palatal needle stick by topical anesthetics: a comparative study between two lidocaine/prilocaine substances." 10/01/2002 - "In an effort to minimize the pain of needle sticks, the use of eutectic mixture of lidocaine and prilocaine (EMLA) has become standard practice in many children's hospitals. "
6.	VaccinesIBA 03/01/2010 - "As most current vaccines are administered by injection by a health care giver, there is the ever-present danger of needlestick injuries. " 01/01/2010 - "Use of dry micro-projection arrays (Nanopatch™) has the potential to overcome the need for a vaccine cold chain for common vaccines currently delivered by needle and syringe, and to reduce risk of needle-stick injury and vaccine avoidance due to the fear of the needle especially among children." 01/01/2000 - "Other advantages of mucosal immunization include a broader age range of recipients, the vaccines are easy and non-invasive to administer and there is no risk of needle stick injury and cross contamination (3)." 04/01/1995 - "Needlestick injuries when using oil-based vaccines are a serious hazard to employees. " 03/24/2015 - "Safe and effective vaccines and drugs are needed for the prevention and treatment of Ebola virus disease, including following a potentially high-risk exposure such as a needlestick. "
7.	Anesthetics (Anesthetic Agents)IBA 09/01/2010 - "Topical anesthetics are more effective in diminishing pain from needle stick insertion alone compared to reducing pain from insertion with anesthetic injection." 01/01/2008 - "Although both topical anesthetic agents are similar in content, the cream seemed to be preferred by the patients and reduced pain from needle stick in the palate significantly better than the thermosetting gel." 04/01/2001 - "Clinical evaluation and comparison of 2 topical anesthetics for pain caused by needle sticks and scaling and root planing." 08/01/1991 - "Particular attention has been devoted to hepatitis B, acquired immunodeficiency syndrome, tuberculosis, cytotoxic drugs, anesthetic agents, needlestick injury, back pain, and stress." 04/01/2001 - "Pain generated by needle sticks (Ns) for the delivery of local anesthetic and/or scaling and root planing (SRP) instrumentation is commonly addressed by the use of topical anesthetics, such as a benzocaine-gel preparation (BGP). "
8.	EMLA FDA LinkGeneric 06/01/2009 - "The mean needle-stick pain score in the EMLA group was significantly lower than in the control group (2.7 vs. 5.7, p<.001, Mann-Whitney U-test). " 07/01/1999 - "They are (1) use of T-cell count as a guideline for therapy, (2) vaccination requirements, (3) the use of EMLA cream or adhesive discs to numb the skin enough to avoid needlestick pain, (4) the issue of possible drug resistance to AZT in children whose mothers took the drug, (5) adherence problems specific to pediatric HIV treatment and how to address them, (6) discussions on side effects with children, (7) CDC guidelines for Pneumocystis carinii prophylaxis for infants born to HIV-positive women, and (8) guidelines published by the U.S. " 06/01/2009 - "EMLA effectively reduces the preprocedural needle-stick pain and procedural pain associated with minor surgical procedures." 08/01/2011 - "After cooperating with mock needle sticks, needle sites were prepared with topical anesthetic (EMLA), then therapists and medical staff implemented the behavioral protocol while completing the actual needle stick(s). " 03/01/2001 - "More wounds treated with LET were anesthetic to a needlestick than wounds treated with EMLA (73% vs 40%, p = 0.01); however, there was no between-group difference in the median pain of lidocaine infiltration (LET-12 mm vs EMLA-13 mm, p = 0.89). "
9.	Naloxone (Narcan)FDA LinkGeneric 03/01/2006 - "The clinical bottom line is that it is likely that intranasal Naloxone is a safe and effective first line prehospital intervention in reversing the effects of an Opioid overdose and helping to reduce the risk of needle stick injury. " 03/01/2010 - "Based on our results, IN naloxone is a viable alternative to IV naloxone while posing less risk of needle stick injury. " 12/01/2009 - "Traditionally, the opiate antagonist naloxone has been administered parenterally; however, intranasal (i.n.) administration has the potential to reduce the risk of needlestick injury. " 02/01/2013 - "Paramedics have used this route to quickly administer naloxone in a needle-free system and avoiding needle-stick injuries and contracting a blood-born pathogen disease such as hepatitis or human immunodeficiency virus. "
10.	Combined VaccinesIBA 01/01/2003 - "Benefits of using combination vaccines in the office setting include reduced missed opportunities to vaccinate, storage of fewer vials, decreased risk of needle sticks as a result of handling fewer syringes, and potentially improved record keeping and tracking. " 01/01/1997 - "The advantages and disadvantages of combination vaccines are set out with a clear indication that, although there are many (described and discussed) influences on in the immunogenicity of a vaccine it would still be of considerable value to be able to deliver such materials with the minimum number of needle-stick injections. " 01/01/2003 - "Reduced administration fees, fewer needed syringes, and decreased risk of needlestick injury resulting from the use of combination vaccines all may have a positive impact on acceptance of these vaccines by managed care organizations. "

Therapies and Procedures

1.	Protective Devices (Safety Device) 04/01/2010 - "Safety devices have proven to be effective in reducing needle stick percutaneous accidents, so that they are a good choice in the primary prevention of biological accidents contact." 12/01/2013 - "Protection against needlestick injuries has significantly improved in recent years thanks to so-called "safety devices." However, a potential drawback occasionally reported by users is a risk of blood splashing. " 09/01/2008 - "Indeed, evidence suggests that the increased acquisition cost of safety devices could be more than offset by savings resulting from the reduced incidence of needlestick injuries. " 08/01/2006 - "A prospective survey was conducted over six months in order to estimate the proportion of reported occupational needlestick injuries sustained by National Health Service (NHS) Scotland staff that could have been prevented through either safety device introduction, improved guideline adherence, guideline revision or a combination of these. " 12/01/2006 - "Sharps injuries in UK health care: a review of injury rates, viral transmission and potential efficacy of safety devices."
2.	Sutures (Suture) 05/01/2008 - "In an effort to reduce needlestick injuries, the use of blunt suture needles is safe and effective for repairs at vaginal delivery." 01/01/2011 - "Randomised controlled trials (RCTs) of blunt versus sharp suture needles for preventing needle stick injuries among surgical staff measured as glove perforations or self-reported needle stick injuries. " 09/01/2015 - "A simple method for maintaining control of sutures to prevent sharps injuries and protect aseptic conditions." 01/01/2014 - "To compare the volume of contaminant transmitted from fluid-coated solid cutting suture needles through the same thickness of the same glove material made up of differing numbers of layers during simulated needlestick injuries. " 06/01/2013 - "The American College of Surgeons (ACS) Statement on Sharps Safety recommends the use of double gloving (DG), hands-free zone (HFZ), and blunt-tip suture needles (BTSN) in the operating room to decrease needlestick injuries. "
3.	Injections 01/01/2012 - "We used a questionnaire to study the frequency and risks of Needlestick Injuries (NSI) associated with diabetic injections in European hospitals. " 03/01/2007 - "The 2001 study had pointed to a low, but non-negligible risk to patients (2% unsafe injections), coupled with a high risk to healthcare workers (61% reported needle-stick injuries in the last 12 months) and to the communities owing to unsafe waste disposal (sharps waste found outside 37% of health facilities, waste disposal considered unsafe in 48% of them). " 06/01/2013 - "In multivariate regression analysis shorter work experience, < 14 years of schooling, > 20 patients per day, administering > or = 30 injections per day, reuse of syringes and needle recapping after use were significantly associated with sharps injury in the past year. " 04/26/2012 - "There had been a reported six needlestick injuries (NSIs) from community clinics administering depot IM injections, which required a review. " 12/01/2011 - "Most frequent circumstances related to needle stick among adult individuals were recapping or discarding used needle while taking care of family member needed home injections (12 cases). "
4.	Surgical Gloves (Surgical Glove) 05/01/2010 - "To compare the efficacy of 4 different types of surgical gloves for preventing exposure to blood as a result of needlestick injury. " 01/01/2014 - "Needlestick fluid transmission through surgical gloves of the same thickness." 03/01/2000 - "We compared the sensitivity of WLT and ECT in detecting glove needle-stick injury in two commonly used brands of surgical gloves. " 01/01/1996 - "A sequential safety program is proposed beginning with the following steps: 1) evaluation and staging of the patient and associated complications; 2) protection of the major surgical and laser instruments; 3) use of an efficient evacuator system to avoid plumes of laser fragments from polluting the operating room environment; 4) protection of the operating room staff with special eye protection including helmets and shields, fluid-soak-resistant fabrics for garments, double surgical gloves, and special orderly trays with safety holders for syringes, needles, sharp instruments, and suture holders; 5) reporting and treatment of accidents, such as needlestick puncture wounds, that require immediate attention and an infectious disease consultation; 6) postoperative care, which includes providing medical health care personnel protection from bloody bandages, needles, and the infectious patient; and 7) and finally, the washing and sterilizing of contaminated instruments by medical health care personnel using face shields and masks, gloves, and protective fabrics for garments. " 07/01/1991 - "An intermediate glove of Kevlar or of Kevlar or cotton impregnated with virucidal compound nonoxynol-9 between standard latex gloves may improve surgical glove safety, compared with latex gloves alone with respect to needlestick transmission of HIV-1. "
5.	Catheters 11/01/2011 - "The objective of the study was to determine if the short-axis approach and long-axis approach to ultrasound-guided peripheral intravenous access (USGPIV) differ in success rate, catheter insertion time, and number of needle sticks. " 02/01/2015 - "A Safe Wing Cath (SWC) is a novel intravenous catheter which has a unique needlestick injury safety mechanism. " 02/01/2014 - "Chorionic villus sampling is an invasive procedure involving an 18-gauge needle stick through the abdomen or passage of a suction catheter through the cervix. " 11/01/2013 - "Comparison of visual versus microscopic methods to detect blood splatter from an intravascular catheter with engineered sharps injury protection." 01/01/2013 - "This article sought to define whether an alternative safety-engineered device (SED) could help prevent needlestick injury (NSI) in healthcare workers (HCWs) who place central venous catheters (CVCs). "