I stepped on a needle in college when I was making a dress for a party. It was the 70's, so it fell into the requisite shag carpeting, where it found its way into my foot, and then broke. Instead of going to the party, I went to the ER for a few hours to have it removed and hobbled around for several days. That experience combined with having a toddler on my sewing room floor a few years later made me cautious.
Ever since then I count my needles and pins. I like using heavy porcelain ramekins next to my machine. One is for straight pins and the other for my safety pins. I like their deep, straight sides and heaviness which increase the odds of pins staying put. I most often use the long quilting pins with the yellow balls, because they are easy to hold and pin. There are silk pins in the bottom of the ramekin that I use for precise pinning with extra careful counting.
I keep my hand sewing needles in the original cases so I can tell if one is missing. I'm still prone to sticking the one I'm using into my shirt placket while I'm sewing, so seeing an empty slot helps me remember to put it back when I'm done for the day. If needles don't come in that sort of pack, I write down how many are in the little container with a Sharpie.
In my youth I also cut the pad off of one of my fingers with newly sharpened scissors and sewed through another finger with the Featherweight. Who knew sewing was a dangerous sport!