20th February 2024

Initial management

This topic will not cover the clinical presentation, investigation or management of hepatitis B, C or HIV. This section aims to ensure candidates know the steps and advice that should be provided when a patient has been accidentally exposed to the body fluids of a suspected carrier of BBVs.  

It is crucial to determine the type of exposure ( Skin vs. mucous membrane vs. percutaneous) along with the type of body fluid the recipient was exposed to. The nature of exposure ( type of needle, the purpose of the needle, how soon the event occurred after contamination of the needle, whether the blood was fresh or dried) should be clarified. 

Following exposure, basic wound care should be undertaken with irrigation of skin, mucous membranes and wounds with soap and water. Antiseptic may be used to clean the wounds, which should be allowed to bleed freely. It is not encouraged to express blood or to suck blood from the wound. Eyes should be irrigated with water. 

It is essential to be aware of the risk of transmission. The risks are reduced for skin and mucous membrane exposure.

Table 1: Risk of infection transmission following a needlestick injury. Information extracted from Health and Safety Executive UK (Health and Safety Executive. (No date). Management of an exposure incident. Accessed on 2022 Mar 26. Available from: https://www.hse.gov.uk/biosafety/blood-borne-viruses/management-exposure-incident.htm. )

A baseline serology sample should be taken from the recipient for all individuals. If the source is not known to have any BBVs, they should be consented to a BBV screen and a serology sample. If the source is positive for any BBV, the stored baseline sample from the recipient will be tested.