Needle-stick injuries; and consent

We're back!

EI has been on holiday in sunny sunny Spain (y Viva España...), although we didn't take a plane to the Costa Brava or anything like that. In fact, we were in one of the highest villages on the Iberian Peninsula, so look out for an altitude physiology article to follow.

In the meantime, a question regarding needlestick injuries has come in, i.e. are there any definitive guidelines. The answer is that there are several documents which have various aspects about what to do when suffering a needlestick injury. We have tried to bring you the ones we consider the most important and most relevant. Also, every trust will have its own set of guidelines, and these should be available from your Microbiology department, A&E (or Emergency Medicine) department or on your hospital intranet.

Take a look at the following links:

DoH Guidance for Clinical Health Care Workers: Protection Against Infection with Blood-borne Viruses (see section 5.12 onwards) (which could be considered definitive)
DoH guidance on Post-Exposure Prophylaxis for HIV
Patient Plus report on Needlestick Injury

Consent

Whilst were on this, and as a result of the fact that there were references to consent for testing for blood-borne viruses, the GMC has published new guidance: Consent: patients and doctors making decisions together.

Bearing in mind that the new Mental Capacity Act 2005 (MCA2005) has now come into force, I would keep a look out for Consent as a hot topic. The AAGBI published guidelines in 2006: Consent for Anaesthesia. Also, the BMA has published guidance on the Mental Capacity Act here.

Consent for anaesthesia has always been a debated topic. Should we take written consent? What risks should we explain? Should we explain nothing at all if the patient tells us just to do what we think is best?

Intensive Care is the area which brings up more issues on consent and capacity, however, as the new Act directly impacts on what will happen. In one trust we are aware that the Consultant in ICU have requested an Independent Mental Capacity Advocate (IMCA) be present at all Multi-disciplinary rounds in order to ensure that they are complying with the Act...

If you want to find out more about the MCA2005, take a look at this link, which explains it all in very simple terms. For something more substantial, try the links on this page.