What is the first action you should take if you have been stuck with a used needle that has been in contact with blood?

Medically Reviewed by Neha Pathak, MD on April 25, 2021

Diseases Spread by Needles
What to Do
Prevention

Needle stick injuries are a reality for people who regularly use needles, like nurses and lab workers. It also can happen if you handle trash, even if it’s not medical waste. According to the CDC, some 385,000 health care workers accidentally stick themselves with needles every year.

Your chances of catching a disease from a single needle stick are usually very low. About 1 out of 300 health care workers accidentally stuck with a needle from someone with HIV get infected. But for hepatitis B, the odds can be as high as nearly 1 in 3 if the worker hasn’t been vaccinated for it.

The dangers are greater if you use drugs and share needles with someone who has a disease. Each time someone injects drugs with a needle used by an HIV-positive person, for example, they have a 1 in 160 chance of getting the virus.

Accidents and sharing needles can pass on many other kinds of viruses and bacteria, including:

When it comes to HIV, your chances of getting it goes up if the needle:

Has blood on it
Was first stuck in someone’s artery or vein
Was used for a very deep injury
Was used on someone who dies within 2 months of the needle stick injury

If you get stuck with a needle, act quickly. With HIV, treatment works best when you get it within the first 72 hours.

1. Wash it. Clean any accidental sticks right away. Rinse and wash the area well with running water and soap. No need to use antiseptics or disinfectants. It’s also a good idea to flush out your eyes, nose, and mouth with water or sterile saline, in case of any splashes from the needle.

2. Fact check it. Find out as much as you can about the person or persons who used the needle before you. It’s especially important to find out if they could have HIV, hepatitis B, or hepatitis C.

3. Get treated. Tell your doctor what happened. Their plan will depend on your situation, including how deep the needle went in, where it stuck you, and your medical history.

If your doctor decides you’re at risk for infection, they can treat it several ways:

Immunization shots. Some vaccine shots, like those for hepatitis B, diphtheria, and tetanus, help your body’s immune system kick in and protect you from those infections.
Nucleoside reverse transcriptase inhibitors. These drugs can stop some viruses from reproducing, or make copies of themselves.
Post-exposure prophylaxis (PEP). Antiretroviral drugs don’t kill viruses. But a short course of these HIV medications, taken within 72 hours of your exposure to the virus, may keep it from taking hold in your body..

4. Report it. Half or more accidental injuries from needles and other sharp medical instruments go unreported. Reporting any injury from an accidental needle stick not only helps you get the right kind of care, it helps shape guidelines for future needle handling so other people stay safe, too.

You’re most likely to get a needle injury while injecting someone. But accidents can happen in other ways

As you’re taking the needle apart to throw away
As you’re throwing it out in a container
As you’re putting the cap back on

These safety tips can help protect you:

Use clean needles. If you inject drugs, check with your local or state health department about how to get free needles and syringes. Also, some nonprofit and advocacy groups run free needle exchange programs.
Go slowly. Rushing can lead to accidents. Take your time when you use needles.
Use safety features. Needle technology has come a long way. Learn and use any devices that can help you avoid accidents.
Don’t recap needles. The U.S. Department of Health and Human Services recommends leaving needle caps off after use, so you spend less time with it.
Always use a sharps container. Always throw away used needles in a container made for sharp objects. This keeps needles out of the trash.

In this series on first aid, we are working to demystify and break down some of the procedures that are followed by first aiders. We have already covered first aid for insect bites and stings, what to do if someone is having an asthma attack and we explained what DRSABCD is.

In today’s blog we are going to talk about what first aiders do when dealing with a needle stick injury.

There are few moments that are quite as fraught with anxiety and uncertainty than when someone discovers they have been stuck with a needle and they don’t know what’s in it.

Needle stick injuries are especially dangerous because when an unknown needle punctures someone’s skin. It puts them at risk of all sorts of blood borne diseases not to mention they are also at risk of whatever was in the needle.

Needle Stick injuries are especially common in the healthcare profession as many healthcare professionals work around and near needles. There are approximately 18,000 needle stick injuries in the healthcare field every year in Australia.

One in nine nurses has reported at least one needle stick injury in the past year.

Needle stick injuries are associated with a risk of blood borne pathogens such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, malaria, mononucleosis, diphtheria, herpes, tuberculosis and syphilis.

If someone has been stuck with an unknown needle and is conscious, then a first aider will follow these steps:

They will reassure a patient. Trying to calm them down and make sure they are comfortable and feel safe. This can be quite a distressing experience and it’s important to keep someone calm when trying to administer first aid.
They will not immediately badge the wound. They let the wound bleed freely for a few seconds.
Then they will wash the wound site with soap and running water if they can. If that’s not possible they might be able to use an alcohol base rub or wash to clean it.
If needed they will apply a sterilizsed, waterproof dressing.
The first aider will then advise that the patient should immediately see their doctor or go straight to the emergency department.
The first aider will recommend that the needle should be kept in a sturdy container with a lid and taken for testing so the patient can know what precautions should be taken from the injury.

If someone has been stuck with a needle and they are not conscious a first aider will immediately follow the DRSABCD Basic Life support plan and call an ambulance.

If you’re interested in being able to offer support and safely assist someone in the event they are stuck with an unknown needle, you can complete our first aid course.

The first aid course only takes one day to complete in a face-to-face workshop with online learning prior to attending. In this workshop you’ll learn how to provide CPR, basic life support and first aid.

Get in touch our course advisors to determine the right First Aid course for your needs.

Per the CDC, a sharps injury is a penetrating stab wound from a needle, scalpel, or another sharp object that may result in exposure to blood or other body fluids. This can include scalpels, razors, needles, lancets, blades, broken glass or any other sharp implement.

The CDC knows there are many needle sticks and sharps injuries that occur during a year in hospitals and healthcare facilities, with over half of them unreported. Most happen innocently, like when nurses are caring for patients, or when a needle is being recapped with two hands. What risks do these injuries pose, and what's the best way to treat and avoid them?

Karl Tapales / Getty Images

First, don't panic. Know that it's OK. Most needlesticks, splashes, and sharps injuries do not result in the transmission of any worrisome infections, so take a deep breath. This situation usually turns out just fine if you follow up, as needed, with a medical provider.

There were 58 known workplace transmission of HIV and 150 suspected cases of HIV due to workplace exposures. It's important to follow up with medical care immediately if there has been an exposure.

If you have just had a needlestick or a sharps injury:

Wash the needlestick site or site of injury with soap and water
Report what happened to your supervisor, if this occurred while on the job
Seek medical treatment immediately

If you've been splashed with blood or a body fluid:

Wash splashes to any abrasions, cuts, or non-intact skin with soap and water
Flush splashes to the eyes with clean water, saline (mild salt water), or sterile eyewash irrigants
Flush splashes to the nose or mouth with water
Wash off any other body fluids that have splashed on you
Report what happened to your supervisor, if this occurred while on the job
Seek medical treatment immediately for any splashes to the face (eyes, mouth, nose) or on non-intact skin (cuts, abrasions, puncture wounds, sores, burns).

Splashes to intact skin should be washed off, but without splashing mucus membranes (mouth, nose, eyes, etc.) or non-intact skin (cuts, abrasions, sores, burns). This probably poses no risk for major blood-borne illnesses, but please follow safety protocols where you work and check with a medical professional about any exposures.

There are certain diseases like HIV, Hepatitis B, and Hepatitis C that can spread through blood exposure and it's important to take any steps immediately to reduce the risk of transmission. Post-exposure prophylaxis refers to medication or other interventions that can reduce the chance of developing a disease after being exposed to an infection. This can mean a daily medication for HIV, or a vaccination and immunoglobulin injection for Hepatitis B.

For HIV exposure, these drugs only need to be taken for 4 weeks (28 days). But it's important that this daily treatment is started as soon as possible. You need to start the drugs within 72 hours, but better yet within the first 24 hours of being stuck.

Medical clinicians in the US can call the Clinicians' Post Exposure Prophylaxis (PEP) Line at 1-888-448-4911for help.

Post-exposure prophylaxis can also be used after someone has been exposed to the infection through rape or through consensual sexual activity.

Always wash away any body fluids and clean any needlesticks or other injuries, but talk to your healthcare provider about whether you actually need treatment. If the needle or sharp has not been used on anyone else, it won't, of course, transmit any infections from anyone else. An injury though can always become infected like any other injury so it's important to keep any injury clean.

If, on the other hand, the needle to sharp had been used on someone else, the source patient (whose blood was on the needle) could transmit infection. But if the person does not have any infections that you might be concerned about, you may not be at risk for anything in particular. This is something you should talk about with a healthcare professional to help understand what risks you may or may not face.

If you're a healthcare provider, you may know whether the patient had HIV, Hep B, or Hep C. Depending on the laws and regulations, there may be a way to quickly find out if the source patient is infected with any of these viruses. This will depend on where you are and what the exposure was. Please talk to your healthcare provider about this.

Likewise, not all body fluids transmit all infections.

HIV is transmitted by:

Blood
Amniotic Fluid
Semen and pre-seminal fluid
Rectal fluids
Vaginal fluid
Breast milk

HIV can also be transmitted by fluids that would only be reached by a needle or scalpel during a medical procedure:

Cerebrospinal fluid
Pleural fluid (that builds up around the lungs)
Synovial fluid (from within joints)
Ascites or Peritoneal fluid (from inside the abdomen)
Pericardial fluid (that builds up around the heart)

However, other fluids would normally have to have blood present to transmit HIV. The risk of HIV transmission is very low, without blood, from:

Urine
Spit
Saliva
Sputum
Sweat
Tears
Feces
Nasal Secretions
Vomit

This means that being spit on is not a risk factor for HIV. Likewise, being scratched also doesn't spread HIV if there is no contact with HIV+ blood.

HIV is also not spread through swimming, the air, mosquitoes, hugging, sharing toilets, sharing food or drinks. Likewise, although Hepatitis B virus can be found in saliva and spit, it is not believed to be spread through kissing or sharing utensils, per the CDC.

Also, the good news is that needles do not remain infectious for long. An old needle, long abandoned on the street, is unlikely to be a risk, but do talk to your healthcare provider about each exposure.

Most Needlesticks and Sharps Injuries affect nurses and doctors. However, some injuries affect those who are not medical professionals. It's important to always stay safe when there are needles, scalpels, or blades around.

A child may try to reach into an overfilled sharps box to pick up a shiny needle. A groundskeeper in a park may be pricked by a needle left on the ground. A police officer or a corrections officer may be injured by someone with a bloody needle or knife. Someone else may worry about their risk because their spouse is a nurse who has had a needlestick. Similar exposures can occur in the home with razors, blades, and even a needle used for a splinter. This can also happen, in rare cases, if a tattoo parlor or a nail salon does not follow necessary safety regulations. There are lots of ways that these sorts of injuries can affect all of us, so seek medical advice if there's any concern for exposure.

In some places, health facilities are not in line with Infection Prevention and Control. This is one reason for the spread of Hepatitis C worldwide. There are times when needles are reused. Sometimes IV fluids or IV tubing are reused. Other times reusable devices are not fully decontaminated between usages. In other cases, needles are used after patient use to obtain more medications from a shared reusable medicine container. Reuse of needles in any form after use in a patient can lead to spreading infections.

It's about being prepared.

Train in safe needle use
Avoid using needles when not necessary
Ensure enough rest when working with needles
Avoid recapping needles
Use only one hand with a needle
Do not rush
Do not walk with a used needle
Do not hand a needle to someone else
Have a proper workspace
Dispose of needles in a sharps disposal box
Discard sharps disposal box before it is full
Never reach into a sharps disposal box
Use needles with safety devices
Use safety blades and razors
Avoid using glass when plastic could work
Consistently use the same type of needle
Report any needlesticks immediately to an employer
Look for risks for needlesticks
Determine why any needlesticks have happened

Just to be on the safe side, don't use needles unless you know what you're doing and you need to. There's a risk in using a needle. Every time you use one it can risk a needlestick. It can also create more risks for the patient (who can always get an infection and pain at the site of the injection). In general, only use needles when well trained to do so and when it's necessary.