I have a little experience with this, given that I had a needle stick as an intern sewing in a central line in the ICU. Patient didn't have big HIV/Hepatitis risk factors and I had a solid needle, so it was low likelihood of transmission. Of course, that was little consolation at the time, and it was all the more painful because my CT attending at the time insisted that we do rounds before I went to the ER for the needle stick protocol.
What I was told at the time about prophylaxis is this: (1) Early administration of retrovirals decrease risk of seroconversion; (2) Antiretrovirals are only strongly recommended when the source patient is known to be HIV positive or has other major risk factors for infection (sex worker, IV drug abuser, etc); (3) Whether or not to take the meds is up to you.
Thanks. My baseline was negative, patient probably didn't have HIV but had nothing documented, and I have a big gaping wound on my thumb with his blood in it. ER doc was worthless, didn't care, made that very clear from the outset ("You know, you probably just could have seen the Occ Health Clinic in the morning for this.") Oh, and wife and daughter are at home.
In the end, I elected not to do the antiretrovirals, and it turned out fine. Still, I got minimal support from anyone, and ended up ordering the infectious disease workup on my own patient (no one could tell me if informed consent from the family was necessary, and I couldn't talk to him because he was intubated). He turned out to be negative for everything, all my tests came back negative, and month later an Occ Health nurse made me come in on my one day off that month for "follow-up".
Moral of my story is this:
(1) Don't stick yourself with a damn needle
(2) Needle sticks are uber common, so consider in advance what you would do in certain circumstances, because trying to figure it out at 1600 on a post-call day is not fun.
(3) There are a handful of times in your life where your personal problems are more important than the opinions of your attendings/residents, your patients' problems, and hospital policy. In those cases, throw up the middle finger and do what needs to be done to take care of yourself.
