What you’ll learn
- Do the right first thing for the route the exposure took
- Avoid the two instincts that make it worse
- Report it to the right person, and know why that matters
- Understand what a medical evaluation actually involves
- Tell an exposure incident from contact that isn't one
It almost never looks like an emergency. A scratch from something you were holding, a splash you half-noticed, a fingertip that stings for a second. The problem is that the size of the injury tells you nothing useful, and the next hour or two matters more than it feels like it should.
So the instructions come first, and the explanations after them.
Do this first
What to do depends on where it landed, and the differences aren't cosmetic — the right answer for skin is the wrong answer for an eye.
Where it landed | What to do now |
|---|---|
A puncture, cut or needlestick | Wash with soap and running water. Let it bleed if it's bleeding. |
A splash in the eye | Flush with clean running water, saline or sterile eye wash. No soap. Take contact lenses out once you've started, not before. |
A splash in the mouth | Spit it out. Rinse with water and spit again, several times. Do not swallow, don't use mouthwash first. |
Broken or chapped skin | Wash with soap and running water, as for a cut. |
Intact, unbroken skin | Wash with soap and water. This is the least serious case — see the last section. |
Keep flushing or rinsing for longer than feels necessary. There's no reliable way to judge "enough" from the inside, and the cost of continuing is nothing.
The two things not to do
The squeezing one is worth pausing on, because almost everybody does it and most people assume they made it up. They didn't. Encouraging a wound to bleed is something first aid actively taught for a long time — it's the same era of advice as sucking the venom out of a snake bite — and the guidance changed underneath it without anybody being told.
Why the next few hours matter
Depending on what you were exposed to, there may be preventive treatment available — and its usefulness is tied to how quickly it starts. The honest framing is that this is measured in hours rather than days, and sooner is meaningfully better than later.
There's one number worth carrying, and it hasn't moved in thirty years: preventive medication against HIV has to start within 72 hours of the exposure to be worth giving at all — and much sooner than that's much better, so treat it as an outer limit rather than a deadline to work back from.
The other half of that sentence matters just as much, and it's the half people don't hear: there's no point at which it stops being worth asking. Past 72 hours it's still recommended that somebody with expertise takes a look, and for hepatitis B, protective treatment can still be worth giving for several days afterward. So if you're reading this two days after something happened and feeling foolish, the useful thing is still to report it and be assessed. The realistic failure here isn't somebody who waits an hour too long — it's somebody who decides that because they have already waited, the moment has passed and there's no point now.
Tell someone today
Every workplace covered by these rules has a written plan with a designated person named in it. Tell them. If you don't know who that is, tell your supervisor — and the fact that you didn't know is worth raising separately, because it means something your employer is required to have in place isn't reaching the people it exists for.
Reporting isn't paperwork for its own sake. It's what starts the medical evaluation, and it's what makes the incident exist — so that if anything comes of it months later, there's a record from the day rather than a recollection.
There are reasons people don't, and they're worth saying out loud rather than pretending otherwise. It felt like your own fault. You're agency or contract staff and not sure who to tell. It seemed too small to make a fuss about. You didn't want it in a file. None of those change what the exposure was, and every one of them leaves you carrying something alone that the system exists to carry for you.
What happens after you report
Knowing the shape of it makes the reporting easier, because most of the dread is about not knowing what you're agreeing to.
A confidential medical evaluation — what happened, what route, how much, and your own vaccination status.
The source person may be tested where that's possible and permitted. Sometimes it isn't, and the assessment proceeds anyway.
Baseline blood tests for you, then follow-up tests over a period afterward.
Preventive treatment if it's indicated — a clinician's decision, informed by the route and the source.
Counseling and follow-up, which are part of what you're owed rather than an extra.
Your vaccination status comes up early, and if you aren't vaccinated against hepatitis B that's a finding about your workplace as much as about you — the vaccine is something your employer must offer. Which of these infections are actually a concern, and how they differ, is a question worth reading when you're calmer than you're now.
What actually counts as an exposure
This is deliberately at the end. If you've just been exposed, doing the useful thing first and reading the definition second is the right order.
An exposure incident means blood or another potentially infectious material reaching your eye, mouth, another mucous membrane, broken skin, or getting under the skin through a puncture or cut. Those are the routes.
Which means the reassuring case is real and worth stating plainly: blood on intact, unbroken skin isn't an exposure incident. Wash it off and get on with your day. Intact skin is a barrier — it's the reason the whole approach is built around routes rather than around contact. The caveat is that you should be honest about "intact": a crack, a hangnail or a graze you had forgotten about changes the answer, which is also why covering broken skin before you start work matters more than it seems to.
Put it into practice
Training scenario:
You're clearing a treatment room at the end of a clinic. Emptying a trash can, you feel a sharp scratch through the bag against the side of your index finger. There's a bead of blood. It's 6:10, the clinician has gone, the practice manager left at five, and you're on an agency contract — this is your third shift here and you don't know anybody's name. Your finger stings and looks like nothing at all.
Walking it through:
The next sixty seconds: soap and running water, and don't squeeze it — which will take deliberate effort, because you'll want to. Let it bleed if it's bleeding. Nothing else goes on it.
Before you go home: you report it today. The two details designed to stop you're the time — everyone senior has gone, so it would be easy to decide this is a tomorrow problem — and the agency contract, which produces the feeling that you're a guest here and this isn't your place to make a fuss. Both are exactly why the preventive window gets missed.
Practically: there will be an out-of-hours contact, an on-call number, or an urgent care service, and your agency has its own reporting route as well as the site's. Use both. And notice the third thing this scenario is really about — you didn't know who the designated person was, on your third shift, which is a gap somebody else should have closed before you ever touched that trash can.
Medically reviewed by Dr. Mary Williams, RN, DC
Check yourself
Three questions on what you just read.