Percutaneous Injuries in Anesthesia Personnel

Anesthesia personnel are at risk for occupationally acquired blood-borne infections from human immunodeficiency virus, hepatitis viruses, and others after percutaneous exposures to infected blood or body fluids. The risk is greater after an infected, blood-contaminated, percutaneous injury, especially from a hollow-bore blood-filled needle, than from other types of exposures. Few data are available on the specific occupational hazards to anesthesia personnel from needles and other sharp devices. Fifty-eight percutaneous injuries (PIs) from anesthesia personnel in nine hospitals were analyzed. Thirty-nine of 58 PIs were from contaminated devices (all needles), and 19 were from uncontaminated devices or of unknown contamination status. Forty-three percent of contaminated percutaneous injuries (CPI) were classified as moderate (some bleeding) or severe (deep injury with profuse bleeding), and most were to health-care workers' hands. Fifty-nine percent of CPI were potentially preventable. Eighty-seven percent of CPI were from hollow-bore needles, and 68% of these were potentially preventable. The largest categories of devices causing CPI were needle on syringe, intravenous (IV) or arterial catheter needle-stylet, suture needle, and standard hollow-bore needle for secondary IV infusion. Most CPI occurred between steps of a multistep procedure (8%), were recapping related (13%), or occurred at other times after use (41%). No CPI were reported from use of needlestick-prevention safety devices. The devices and mechanisms of injury identified in this study provide specific data that may lead to prevention strategies to reduce the risk of PI. (Anesth Analg 1996;83:273-8)

[1]  G. Ippolito,et al.  Hepatitis C virus infection in healthcare workers. , 1995 .

[2]  H. Turndorf,et al.  Accidental needlesticks: do anesthesiologists practice proper infection control precautions? , 1995, The American journal of anesthesiology.

[3]  B. Lanphear,et al.  Hepatitis C Virus Infection in Healthcare Workers: Risk of Exposure and Infection , 1994, Infection Control & Hospital Epidemiology.

[4]  A. Tait,et al.  Prevention of Occupational Transmission of Human Immunodeficiency Virus and Hepatitis B Virus Among Anesthesiologists: A Survey of Anesthesiology Practice , 1994, Anesthesia and analgesia.

[5]  G. Ippolito,et al.  Device-specific risk of needlestick injury in Italian health care workers. , 1994, JAMA.

[6]  N. Gajraj,et al.  Eutectic Mixture of Local Anesthetics (EMLA®) Cream , 1994, Anesthesia and analgesia.

[7]  R. Howard,et al.  Quantity of blood inoculated in a needlestick injury from suture needles. , 1994, Journal of the American College of Surgeons.

[8]  L. J. Short,et al.  Risk of occupational infection with blood-borne pathogens in operating and delivery room settings. , 1993, American journal of infection control.

[9]  J. Gerberding,et al.  Efficacy of gloves in reducing blood volumes transferred during simulated needlestick injury. , 1993, The Journal of infectious diseases.

[10]  G. Ippolito,et al.  The Risk of Occupational Human Immunodeficiency Virus Infection in Health Care Workers: Italian Multicenter Study , 1993 .

[11]  G. Ippolito,et al.  The risk of occupational human immunodeficiency virus infection in health care workers. Italian Multicenter Study. The Italian Study Group on Occupational Risk of HIV infection. , 1993, Archives of internal medicine.

[12]  A. Berry The Use of Needles in the Practice of Anesthesiology and the Effect of a Needleless Intravenous Administration System , 1993, Anesthesia and analgesia.

[13]  R. Skolnick,et al.  Evaluation and implementation of a needleless intravenous system: making needlesticks a needless problem. , 1993, American journal of infection control.

[14]  E. Greene,et al.  The Risk of Needlestick Injuries and Needlestick-transmitted Diseases in the Practice of Anesthesiology , 1992, Anesthesiology.

[15]  M. Roizen,et al.  Risk of Human Immunodeficiency Virus in Surgeons, Anesthesiologists, and Medical Students , 1992, Anesthesia and analgesia.

[16]  S. Maree The human immunodeficiency virus: knowledge and precautions among anesthesiology personnel. , 1992, Journal of clinical anesthesia.

[17]  E. Hunt,et al.  Impact of a Shielded Safety Syringe on Needlestick Injuries Among Healthcare Workers , 1992, Infection Control & Hospital Epidemiology.

[18]  E. Hunt,et al.  Impact of a shielded safety syringe on needlestick injuries among healthcare workers. , 1992 .

[19]  K. Gartner Impact of a needleless intravenous system in a university hospital. , 1992, Journal of healthcare materiel management.

[20]  J. Downs,et al.  The human immunodeficiency virus: knowledge and precautions among anesthesiology personnel. , 1991, Journal of clinical anesthesia.

[21]  J. Busby Through the valley of many shadows. HIV infected physicians. , 1991, Texas medicine.

[22]  R. Marcus Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus. , 1988, The New England journal of medicine.

[23]  R. Pearson,et al.  Rates of needle-stick injury caused by various devices in a university hospital. , 1988, The New England journal of medicine.

[24]  A. Berry,et al.  The Prevalence of Hepatitis B Viral Markers in Anesthesia Personnel , 1984, Anesthesiology.

[25]  R. Purcell,et al.  Type B hepatitis after needle-stick exposure: prevention with hepatitis B immune globulin. Final report of the Veterans Administration Cooperative Study. , 1978, Annals of internal medicine.

[26]  Public Health Service inter-agency guidelines for screening donors of blood, plasma, organs, tissues, and semen for evidence of hepatitis B and hepatitis C. , 1991, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[27]  Guidelines for prevention of transmission of human immunodeficiency virus and hepatitis B virus to health-care and public-safety workers. , 1989, MMWR supplements.