What immediate steps should I take when a healthcare worker presents with a needlestick injury?

Immediate management steps for a healthcare worker sustaining a needlestick injury:

• Immediately wash the skin and any wounds thoroughly with soap and water; do not suck the wound or squeeze it to express blood.
• Irrigate mucous membranes (e.g., eyes) with water or saline before and after removing contact lenses if applicable.
• Encourage puncture wounds to bleed freely but do not suck them.
• Small wounds and punctures may be cleansed with an antiseptic such as an alcohol-based hand hygiene solution.
• Report the incident according to local policy and to the Health and Safety Executive (HSE) as required.
• Seek urgent medical assessment immediately, ideally at an Accident and Emergency department or HIV/sexual health clinic, for consideration of post-exposure prophylaxis (PEP).
• PEP should be started as soon as possible, ideally within 24 hours of exposure, and no later than 72 hours.
• Follow local guidelines and ensure rapid 24-hour access to urgent advice and PEP.
• Arrange follow-up including HIV testing at 8–12 weeks post-exposure.

These steps are critical to reduce the risk of HIV transmission and other bloodborne infections following occupational exposure to potentially infected bodily fluids.

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