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Needlestick injury
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Needlestick injury management procedure
Post-exposure prophylaxis (PEP) for Hepatitis B

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Post-exposure prophylaxis (PEP) for Hepatitis B

Infectious diseases

See the needlestick injury immediate care and BBV risk assessment flowchart for recommended actions.

Most HCWs are vaccinated against HBV (and may know their anti-HBs titre). Irrespective of type of exposure:

All fully vaccinated HCWs should be offered a HBV booster
All non/partially vaccinated HCWs should start/complete a course of HBV vaccine. Those with previous HBV infection require no prophylaxis.

HBV accelerated vaccination

Doses at 0, 1 and 2 months (alternatively, 0, 7 & 21 days if more pragmatic) with a booster dose at 12 months.
See current BNF for adult and paediatric doses.

Administering Hepatitis B immunoglobulin (HBIG)

Where indicated, give HBIG as soon as possible and ideally within 48hrs (but can be considered up to a week post-exposure).

HBIG is held in the RIE Emergency department. Dose:

Adult and child over 10yrs, 500IU by IM injection
Children <10yrs: contact the paediatric ID consultant at RHCYP (Unavailable: See Where to get expert advice). Do not co-administer HBIG and HBV vaccine at the same site.

Follow-up for HBV

Those with Significant Exposure should be referred for follow-up testing.
Follow up testing should be scheduled as per Table 1.
Follow up everyone who received a course of vaccine.
Individuals don’t need follow-up HBV testing if they are pre-exposure vaccine responders, and anti-HBS titre >100mIU/ml 2-3 months after a full course of vaccine.