Needle-Stick Injury — Immediate Steps & PEP Protocol

Needle-stick injuries are among the most common occupational hazards for healthcare workers — and timing is the most critical factor. For HIV prevention, the sooner PEP (post-exposure prophylaxis) is started, the more effective it is. This guide is based on WHO/CDC guidelines.

The first 10 minutes — 6 steps (order matters)

1. Wash the site — with soap and running water, for 15 minutes under the flow. Only the exposed area (where the needle went in).
2. Do not squeeze — pressing the wound or trying to expel blood goes against the evidence. Let natural bleeding happen.
3. Antiseptic + dressing — clean the wound and cover it (until medical assessment).
4. Report IMMEDIATELY — to your supervisor or infection control team. This is not a "formality" — PEP assessment starts here. Follow hospital protocol.
5. PEP assessment ASAP — ideally within 2 hours, max 72 hours. The hospital team will also handle the source patient's HIV/HBV/HCV testing protocol.
6. Document — time, device, procedure, whether gloves were worn. This data also serves future prevention.

What PEP is — in plain terms

Post-exposure prophylaxis (PEP) is a 28-day course of antiretroviral (ARV) medicines that can protect an HIV-negative person from HIV after an exposure. It works like the concept of emergency contraception — it is taken after the exposure, and taking it early is essential.

• Who needs it: A doctor will do the risk assessment — the source patient's status, depth of injury and device type (hollow-bore needle = higher risk) are all considered
• The 28-day course must be completed — stopping midway is not effective
• Follow-up testing schedule (6 weeks, 3 months, 6 months) per hospital protocol

Prevention — avoiding injury next time

• Do NOT recap needles — this is the most common cause. Put them straight into the sharps container
• Replace sharps containers when three-quarters full — never let them overflow
• Don't rush or get distracted during procedures — calm, focused movements
• Use safety-engineered devices if available in your hospital
• Hands-on sharps handling training — should be compulsory for new staff

Is it normal to feel this way?

Yes — after a needle-stick, anxiety, anger or the "it was my fault" feeling are all very common. It is not weakness. Talk to your occupational health team or a counsellor. Burnout and stress increase clinical errors — patient safety is connected to this too.

Disclaimer: This article is general wellness information for educational purposes — not a substitute for professional medical advice, diagnosis or treatment. Follow your hospital's infection control protocol and the guidance of your occupational health team. In an emergency, call 112 (India) immediately.