Nadelstichverletzung

A Nadelstichverletzung is what happens when a used cannula, a lancet or a broken sample tube penetrates the skin of the person handling it. In a pharmacy the exposure window is narrow and predictable. It opens during the puncture, it widens while the tube is exchanged, and it is at its widest in the seconds after the cannula leaves the vein during a venöse Blutentnahme and before it reaches the disposal container. Routine offers no protection here. Most reported events involve staff who have carried out the procedure hundreds of times.

The first minutes follow one sequence. Bleeding from the wound is allowed to continue for a short moment rather than being stopped, and the site is then rinsed and treated with an alcohol based antiseptic for the contact time printed on the product. Squeezing or scrubbing the surrounding tissue is not part of the sequence. The wound is covered afterwards. If blood reaches an eye, the mouth or broken skin elsewhere, rinsing is immediate and generous. Nothing beyond this belongs in the hands of the pharmacy team.

A Nadelstichverletzung is an Arbeitsunfall and the pharmacy documents it as one. It is entered in the Verbandbuch with the time, the activity and the circumstances, and the injured person is sent to a Durchgangsarzt the same day rather than the following week. The Durchgangsarzt takes the case over for the Unfallversicherungsträger, arranges the baseline serology and decides on any further step. That decision is a medical one and stays with the physician. Serology is normally taken from the injured person, and from the person whose blood was being collected only where that person agrees. The consent for it is asked for explicitly and never assumed.

Treating the event as a scratch is the common failure, and it is the one that later costs an employee their cover, because an injury that was never reported is hard to attribute months afterwards. Prevention is regulated rather than left to preference. TRBA 250 requires cannulas with an integrated safety mechanism, forbids recapping and places the disposal container within reach of the seat. Persönliche Schutzausrüstung and the wider routine set out under Hygiene bei der Blutentnahme carry the rest. A pharmacy that has walked through the sequence once in advance, on a quiet morning, handles the real event far better than one reading the folder while the wound is still open.