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Section 2. Recommendations for Care of Children in Special Circumstances
INJURIES FROM DISCARDED NEEDLES IN THE COMMUNITY
Contact with and injuries from hypodermic needles and syringes presumably discarded in public places by injection drug users are perceived by some people as posing a significant risk for transmission of bloodborne pathogens, especially human immunodeficiency virus (HIV). Although these injuries may pose less of a risk than needlestick injuries that occur in health care settings, the injured person often needs evaluation and counseling. Even if the possibility that the discarded syringe might contain a bloodborne pathogen can be estimated from the prevalence rates of these infections in the local community, the need to test the injured or exposed person usually is not influenced significantly by this assessment.
Management of people with needlestick injuries includes acute wound care, consideration of the need for prophylaxis, and prevention. Standard wound cleansing and care is indicated; such wounds rarely require closure. Tetanus toxoid and Tetanus Immune Globulin should be administered as appropriate for the immunization status of the victim (see Tetanus, p 611).
Consideration of the need for prophylaxis for bloodborne viruses, namely hepatitis B virus (HBV), HIV, and hepatitis C virus (HCV), is the next step in exposure management. Risk of acquisition of various pathogens depends on the nature of the wound, the
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