The clumsy staff member has appeared in Question 25 from the first paper of 2007, Question 5 from the first paper of 2015 and Question 18 from the second paper of 2017. These questions have all been essentially identical: in each, a registrar is putting in a central line, they stab themselves, and you are asked to manage the situation. In the most recent questions the patient was also identified as an intravenous drug user, to add a layer of social cynicism.
As far as reading about this for the exam, LITFL have an excellent short and sweet article on the approach to staff needlestick injuries. David Tripp's notes for the fellowship exam are also a source of a nice point-form algorithm. A list of definitive sources for this information would include the 2017 NSW Health Policy Directive: HIV, Hepatitis B and Hepatitis C - Management of Health CareWorkers Potentially Exposed, as well as the Westmead Children's Hospital procedure "Needlestick and Blood Exposure Injuries: Health Care Worker".
An answer to this question, as a summary of the abovementioned references:
- Abort procedure / delegate / ensure patient is safe
- Express blood, wash wound
- Report incident
- Risk assessment (big needle, large volume)
- Test patient and staff member serology with written consent
- Discuss with ID, arrange follow-up (6 weeks and 6 months)
- Safe sex for 6 months
The following are associated with an increased risk of transmission:
Wicker, Sabine, et al. "Determination of risk of infection with blood-borne pathogens following a needlestick injury in hospital workers." Annals of occupational hygiene 52.7 (2008): 615-622.
McGovern, Patricia. "Needlestick injuries among health care workers: a literature review." AAOHN Journal 47 (1999): 237-244.
2017 NSW Health Policy Directive: HIV, Hepatitis B and Hepatitis C - Management of Health CareWorkers Potentially Exposed
Westmead Children's Hospital procedure: "NEEDLESTICK AND BLOOD EXPOSURE INJURIES: HEALTH CARE WORKER"