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Independents' Day

Practice dilemma: Sharps box injury

During a consultation, a child puts his hand into the sharps box and scratches his hand. The mother is furious. What should you do?


In this situation, your first concern should be for the welfare of the child. You should examine the child and administer first aid as required.

Although the injury itself is likely to be trivial, the mother's concern will almost certainly be the risk of contracting a communicable disease.  You should apologise to her for the incident and acknowledge her concerns.

It would be prudent to seek immediate advice from a paediatrician and /or infectious disease consultant about the level of risk and whether or not there is a need for testing, prophylaxis or monitoring. You should ensure that any follow up or further treatment is arranged by the practice and that the mother understands the reason for it.

It is the practice's responsibility to ensure that all potential hazards on the premises are indentified and appropriate precautions taken to prevent risk of harm to staff and patients. Once the immediate situation is under control your practice needs to conduct a risk assessment and consider what steps should be taken to reduce the risk of a similar event occurring in the future.

The incident should be logged and investigated in accordance with your practice's adverse event protocol. The outcome of this investigation should be communicated to the child's mother with acknowledgment of any lessons learned and any changes made to practice procedures as a result.

If your practice receives a formal complaint following the incident you should contact your defence organisation for further advice. You should also ensure that the practice notifies its public liability insurer as any claim which may arise from the incident is likely to fall to them to deal with.

Dr Janet Page is a medicolegal adviser at the Medical Protection Society

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