Upon receiving an incident report that a pediatric nurse was scratched by a 'needle' in a patient's room while spiking an intravenous bag, what should be the first action?

• A. Determine whether a blood or bodily fluid exposure actually occurred.
• B. Notify the nurse's supervisor.
• C. Begin antimicrobial prophylaxis immediately.
• D. Document the incident and await further details.

Answer: (A)

Assessing whether there was actual exposure to blood or bodily fluids is the first action after a potential needle-stick incident. This determination guides all subsequent steps: if exposure is confirmed, you immediately activate the post-exposure protocol, which includes reporting the event, evaluating the source patient, obtaining baseline tests, and considering post-exposure prophylaxis based on the risk. If no exposure occurred, you can document the incident and review practices without triggering prophylaxis or extensive follow-up. Antimicrobial prophylaxis isn’t started automatically; it’s used only after a risk assessment shows a meaningful exposure. While notifying a supervisor and documenting the incident are important, they follow the initial exposure determination. The essential point is that the first action is to determine whether exposure occurred to guide the correct next steps.