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Needle-stick injuries within surgical specialties remains and
intractable occupational hazard and most of the issues in New York are
applicable in the UK. Trends in the levels of reporting seem similar to
those in previously published studies (1,2). Many factors surrounding the
circumstances in which the injuries occur, contribute to the low reporting
rate. Often junior colleagues can find themselves working alone on lists
when they experience a needle-stick injury. In such situations there is a
pressure to complete operations as frequently it is not practical to find
a replacement. As mentioned most of these injuries occur during the
procedure – what is one to do with a patient on the table?
Incident reporting forms can take a significant time to complete when
needle-stick injuries occur. When a patient is involved as a donor in such
incidents, consent needs to be obtained so that they can be screened. Not
only that but they have to be counselled with regard to the viruses being
tested for and as good practice dictates this should be by personnel who
are not involved. The process is made more difficult that in a proportion
of cases the donor is a patient who has had general anaesthesia. We have
observed that mental risk assessment with regard to the background of the
patient involved, surgeons can at times perform before embarking on such a
course. It is not a replacement for proper reporting.
Out of hours another barrier to prompt management is that there is
often no access to occupational health services. Yes good advice is
readily available over the phone - but over half of affected healthcare
personnel will be forced to attend the Emergency Department (3).
Increasingly and possibly rightly so no preferential treatment is given to
staff to receive immediate treatment. Long waits in Emergency Departments,
in addition to the time it takes to get there, means that the window for
treatment in terms of HIV prophylaxis can be missed.
The situation will not change until there is greater compulsion for
surgeons to report needle-stick injuries with parallel improvements in the
ease of access to hospital services.
1. Elmiyeh B, Whitaker IS, James MJ, Chahal CA, Galea A, Alshafi K.
Needle-stick injuries in the National Health Service: a culture of
silence. J R Soc Med. 2004 Jul;97(7):326-7
2. Wallis GC, Kim WY, Chaudhary BR, Henderson JJ. Perceptions of
orthopaedic surgeons regarding hepatitis C viral transmission: a
questionnaire survey. Ann R Coll Surg Engl. 2007 Apr;89(3):276-80
3. Johnston JJ, O'Conor E. Needlestick injuries, management and
education: a role for emergency medicine? Eur J Emerg Med. 2005
Feb;12(1):10-2.
Competing interests:
None declared
Competing interests:
No competing interests
12 July 2007
Chidi C Ekwobi
Clinical Fellow in Plastic Surgery
Dilnath A. Gurusinghe
The Royal Preston Hospital, Sharoe Green Lane, Preston, PR2 9HT
Under-reporting of needlestick injuries is a universal problem
Needle-stick injuries within surgical specialties remains and
intractable occupational hazard and most of the issues in New York are
applicable in the UK. Trends in the levels of reporting seem similar to
those in previously published studies (1,2). Many factors surrounding the
circumstances in which the injuries occur, contribute to the low reporting
rate. Often junior colleagues can find themselves working alone on lists
when they experience a needle-stick injury. In such situations there is a
pressure to complete operations as frequently it is not practical to find
a replacement. As mentioned most of these injuries occur during the
procedure – what is one to do with a patient on the table?
Incident reporting forms can take a significant time to complete when
needle-stick injuries occur. When a patient is involved as a donor in such
incidents, consent needs to be obtained so that they can be screened. Not
only that but they have to be counselled with regard to the viruses being
tested for and as good practice dictates this should be by personnel who
are not involved. The process is made more difficult that in a proportion
of cases the donor is a patient who has had general anaesthesia. We have
observed that mental risk assessment with regard to the background of the
patient involved, surgeons can at times perform before embarking on such a
course. It is not a replacement for proper reporting.
Out of hours another barrier to prompt management is that there is
often no access to occupational health services. Yes good advice is
readily available over the phone - but over half of affected healthcare
personnel will be forced to attend the Emergency Department (3).
Increasingly and possibly rightly so no preferential treatment is given to
staff to receive immediate treatment. Long waits in Emergency Departments,
in addition to the time it takes to get there, means that the window for
treatment in terms of HIV prophylaxis can be missed.
The situation will not change until there is greater compulsion for
surgeons to report needle-stick injuries with parallel improvements in the
ease of access to hospital services.
1. Elmiyeh B, Whitaker IS, James MJ, Chahal CA, Galea A, Alshafi K.
Needle-stick injuries in the National Health Service: a culture of
silence. J R Soc Med. 2004 Jul;97(7):326-7
2. Wallis GC, Kim WY, Chaudhary BR, Henderson JJ. Perceptions of
orthopaedic surgeons regarding hepatitis C viral transmission: a
questionnaire survey. Ann R Coll Surg Engl. 2007 Apr;89(3):276-80
3. Johnston JJ, O'Conor E. Needlestick injuries, management and
education: a role for emergency medicine? Eur J Emerg Med. 2005
Feb;12(1):10-2.
Competing interests:
None declared
Competing interests: No competing interests