“I Got Stuck!” Blood Exposure in the OR: Prevention and Management of Sharp Injuries and Infectious Disease Exposure

Exposure to blood-borne pathogens is an important risk in healthcare. The practice of medicine has always been associated with health hazards. However, with the new technological development and more invasive procedures—and despite advances in safety as well as regulation, control, and oversight—accidents still occur and healthcare workers are subject to blood-borne pathogen exposures. In addition to the risk of transmitted infections, these exposure incidents are also usually associated with major psychological stress to the exposed individual and significant cost to the healthcare system. We will briefly review in this chapter the epidemiology and background of blood-borne exposure in healthcare settings. We will focus on the three most common pathogens: HIV, hepatitis B, and hepatitis C, and throughout the chapter, we will use the guidelines and nomenclature by the Centers for Disease Control and Prevention (CDC), the Occupational Safety and Health Agency (OSHA), and the World Health Organization (WHO). In our review, we will describe the transmission risk associated with occupational exposures to those pathogens, the plan of care and testing, as well as the necessary interventions and procedures to prevent infection after exposure. We will also review the procedures in place and make recommendations that could be easily adopted by individual practitioners and institutions. Prevention of these accidents is one of the most important safety initiatives that aims to decrease occupational injuries in the healthcare sector.