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Mała rana o ogromnym znaczeniu. Postępowanie i ryzyko przy przypadkowym zakłuciu igłą

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Ten tekst przeczytasz w 2 min.

Choć rana przy zakłuciu igłą nie jest duża, to niesie ze sobą poważne ryzyko zakażenia takimi chorobami jak HBV, HCV oraz wirusem HIV. W przypadku pojawienia się ekspozycji na materiał potencjalnie zakaźny niezwykle ważna jest szybka reakcja i znajomość procedur, które zmniejszają ryzyko zakażenia.

Przypadkowe zakłucie igłą jest jednym z rodzajów tak zwanej ekspozycji zawodowej, na którą narażeni są pracownicy opieki zdrowotnej. Zakłucie sterylną igłą nie stanowi zagrożenia dla zdrowia. Sytuacja ulega zmianie w momencie przeprowadzenia badań sprawdzających, czy pacjent jest zakażona wirusem HBV, HCV lub HIV, ale nie zawsze jest to możliwe do ustalenia.

Jak postępować przy zakłuciu igłą?

W przypadku kontaktu z krwią pacjenta poprzez zakłucie igłą pierwszym krokiem jest przemycie rany pod bieżącą wodą, a następnie umycie miejsca wkłucia wodą i mydłem. Co istotne, nie zaleca się dezynfekowania rany. Nie powinno się też tamować krwawienia ani wyciskać krwi z miejsca, gdzie została wbita igła.

Niezbędne jest też sporządzenie odpowiedniej notatki oraz zgłoszenie całego zajścia do przełożonego. Notka powinna zawierać szczegółowy opis całego zajścia, a także jego okoliczności.

Postępowanie przy podejrzeniu zakażenia HBV

Najczęstszym zakażeniem wywołanym przez kontakt z zakażoną krwią jest wirusowe zapalenie wątroby typu B. Z tego względu wszyscy pracownicy ochrony zdrowia powinni przejść szczepienie chroniące przed tą infekcją. Szczepienie znacząco zmniejsza ryzyko wystąpienia zakażenia, ale nie daje pewności czy mimo wszystko do niego nie dojdzie. Przez to zaleca się pobranie krwi pacjenta, aby określić czy nie jest on chory na wirusowe zapalenie wątroby typu B. W przypadku negatywnego wyniku testu nie ma potrzeby wdrażać dodatkowych procedur. Przy dodatnim wyniku badania należy oznaczyć ilość przeciwciał anty HBs u osoby zakłutej igłą. Jeżeli poziom przeciwciał jest zbyt niski, należy podać szczepienie ochronne.

Postępowanie przy podejrzeniu zakażenia HCV

Niestety w przypadku wirusowego zapalenia wątroby typu C nie istnieją środki, które zapobiegają zakażeniu. Gdy istnieje ryzyko zakażenia HCV, osoba, u której doszło do zakłucia, powinna przeprowadzić badania krwi pod kątem rozwoju choroby po 3 i 6 miesiącach od dnia ekspozycji. Zaleca się również comiesięczne badania poziomu LDL. W sytuacji rozwoju choroby należy natychmiastowo rozpocząć leczenie, którego skuteczność jest tym większa, im szybciej zostanie wdrożone.

Postępowanie przy podejrzeniu zakażenia wirusem HIV

Kiedy nie można wykluczyć zakażenia wirusem HIV, należy jak najszybciej rozpocząć stosowanie chemioprofilaktyków. Są to środki antyretrowirusowe, których zadaniem jest niedopuszczenie do tego, aby wirus namnożył się, co doprowadziłoby do rozwoju choroby. Leki powinny zostać podane już w pierwszych godzinach po ekspozycji. Terapia trwa 28 dni lub do momentu otrzymania negatywnego wyniku na obecność wirusa w krwi pacjenta.

 

Przeczytaj także: Coraz więcej operacji w Polsce przeprowadzanych jest z użyciem robota

Przeczytaj bezpłatnie pokrewny artykuł w czasopiśmie „Pielęgniarstwo w Anestezjologii i Intensywnej Opiece”:

Poziom wiedzy personelu medycznego na temat zasad zapobiegania zakażeniom szpitalnym, w tym postępowania po ekspozycji zawodowej na krew i inny potencjalnie zakaźny materiał

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442 thoughts on “Mała rana o ogromnym znaczeniu. Postępowanie i ryzyko przy przypadkowym zakłuciu igłą”

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  182. Эмпайр скважин на воду – этто эпидпроцесс учреждения отверстий в течение почве для доступа ко находящийся под землей гидрофитным ресурсам. Этто важная электропроцедура для получения неинтересной воды – https://ctxt.io/2/AABQiwuqEw. Эмпайр исполняется специальными компаниями с приложением особенного оборудования. Перед основой бурения прокладывается геологическое и гидрогеологическое исследование для определения места бурения. Бурильная энергоустановка проходит в течение вселенную, творя отверстие. После актив водоносного слоя скважина обсаживается особенными трубами. Прочерчивается электроиспытание сверху водичку, равным образом в течение случае успеха щель оборудуется насосом чтобы извлечения воды. Эмпайр скважин на воду спрашивает специализированных познаний а также опыта, что-что также соблюдение общепризнанных мерок а также правил для неопасности (а) также действенности процесса.

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