Am I paranoid about fear of needles sticks?

[fj25]

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I have this fear of needle sticks and catching some disease. I think it may stop me from doing certain fields of medicine. Is that something I shouldnt worry about? I also noticed that in the hospital people tend to get lazy sometimes and spill blood/body fuilds and dont clean it up. That tends to make my skin crawl.

 

[robotsonic]

If you look at the numbers, you are very unlikely to get something bad from a needlestick. According to the CDC, getting stuck with a needle from a patient with hep C is 1.8%. With an HIV/AIDS patient, the risk of contracting HIV is 0.3%. If you are not vaccinated against hep B, the risk is higher, but if you are vaccinated it is close to zero.
With other exposures, like blood in your eyes, mouth, etc, the risk is lower.

Read this from the CBC for more stats.

Having said all of that, is there a chance that you have an anxiety disorder related to this fear?

 

[robotsonic]

Oh, and I have been stuck. It was third year during my surgery rotation. We were pretty sure the patient didn't have hep C or HIV, so I just poured some bleach on it and put on a new set of gloves. And I'm not worried about it. Talk to a surgeon. Getting stuck is like a rite of passage (and most of them can share many stories in which they were stuck or they stuck someone else). It happens, and only rarely do people get sick from it.

 

[RonaldColeman]

Oh, and I have been stuck. It was third year during my surgery rotation. We were pretty sure the patient didn't have hep C or HIV, so I just poured some bleach on it and put on a new set of gloves. And I'm not worried about it. Talk to a surgeon. Getting stuck is like a rite of passage (and most of them can share many stories in which they were stuck or they stuck someone else). It happens, and only rarely do people get sick from it.

To the OP:

Don't buy into this b*ll****. It's not a rite of passage to get stuck by a needle. Yes, the transmission rates for certain diseases are low, but they are not 0, and you have every right to protect yourself. Also, do not use appearance as a barometer of HIV status. I've been suprised by a number of the HIV+ people I have seen.

 

[allylz]

To the OP:

Don't buy into this b*ll****. It's not a rite of passage to get stuck by a needle. Yes, the transmission rates for certain diseases are low, but they are not 0, and you have every right to protect yourself. Also, do not use appearance as a barometer of HIV status. I've been suprised by a number of the HIV+ people I have seen.

I think you're misconstruing the response. Getting stuck is a rite of passage meaning that it happens to everyone who works with needles. I'm not sure why you say it's not a rite of passage, maybe because you think that means it's not being taken seriously enough or because you think no one would be stuck with needles if we were just a little more careful? I agree, people could probably take the issue more seriously, but people are not machines, they make mistakes and people get stuck all the time. I think it's pretty awful that I have heard that a lot of surgeons couldn't care less about a student getting stuck, but if it happens purely by accident I don't see where the controversy is.

Also, I don't think the poster was implying that he/she used appearance as a barometer of HIV status- presumably he/she had access to the patient's chart in order to verify this kind of information. There are a lot of HIV+ people out there but you're a lot more likely to get it from anal sex rather than getting stuck by a needle. Think about it this way - working with sick people means taking risks. Even if you never got near a needle that doesn't mean you won't get TB or some other crazy infectious disease, because you're going to be around sick people all the time. I hear stories about residents getting C. diff or other rotten illnesses all the time. You can't avoid dealing with sick people when you work in a hospital, you just have to take every precaution you can to avoid getting sick (and avoid spreading diseases amongst your patients, too!) - think about all the people that don't wash their hands every day in a hospital! I imagine you have a lot more to fear from that than from needlesticks.

 

[robotsonic]

allylz,

Thanks for your reply; you are correct in your assessment of my post. I was in no way saying that med students should be careless about needles. And by saying it was a rite of passage I was not implying that we should all go and stick ourselves. I was just saying that when you work with needles and scalpels, etc, you have a pretty good chance of getting stuck at some point in your career, and in the great majority of cases, there will be no negative consequences. And I also believe that when you are in the medical profession, you always have that risk of contracting an illness that you are working with - that is just part of being a physician.

And no, I did not guess the guy's HIV or hep C status based on how he looked - I based it on his chart, as he had been tested for these recently. We all know that someone can appear healthy and have HIV or hep C.

 

[doclm]

I have worked in a lab for the past 1.5 years where we have to draw blood from many patients. From my experience, not too many people stick themselves with needles. And if they do get stuck, there is a protocol to follow which includes: wash site of injury, contact health services, get the patients blood drawn, get your blood drawn, and if the patient has HIV or something serious there is about 24 hour window to take some special medications to help you from contracting the virus. If you happen to contract something else that cannot be cured, make sure to have this documented at your medical institute. They will be obligated to pay for your treatments if ever needed. 🙂

 

[RonaldColeman]

Thanks for the civil response. I probably could have been a little more tactful...

I understood what the poster meant by "rite of passage." Having only recently been "cleared," so to speak, following a stick, I guess I'm hypersensitive. I still think doctors, especially some of the old-school surgeons, take the issue of needle sticks too lightly.
My advice to the OP is to do whatever is necessary to protect yourself. Always follow the protocols for needlestick injuries. Never listen to the surgeons who tell you that someone "looks clean." Also, it's not just needlesticks that you need to worry about. Mucosal splashes can transmit disease, and there are at least 2 cases in the literature of individuals acquiring HIV from skin exposure. I always gown up and use a face shield even if it's for something simple done at the bedside.

 

[IlianaSedai]

I have this fear of needle sticks and catching some disease. I think it may stop me from doing certain fields of medicine. Is that something I shouldnt worry about? I also noticed that in the hospital people tend to get lazy sometimes and spill blood/body fuilds and dont clean it up. That tends to make my skin crawl.

I think it's a realistic concern. Any procedural specialty (surgery, EM, anesthesia, interventional cardiology and radiology for example) is going to carry some risk of sharps injury. All specialties (including psychiatry and pathology) do involve use of some sharps, however rarely. When you choose the specialty, you do have to walk into it with open eyes and be aware that injury with sharps does happen. But I don't think the risk of injury/infection will make or break your decision -- you'll see when you start doing clerkships.

My arsenal of things learned as med student:

- Once you develop a safe routine, follow it EVERY time and don't take shortcuts or deviate from it. Deviation from safe routines causes accidents.

- Know where your hospital's employee health office is and what to do / where to go if you do get an injury.

- Double glove EVERY time you scrub into a surgical case. I was very glad for it when I ended up scrubbed in next to a fourth year (fourth year!) general surgery resident who was waving her scalpel, bovie, etc ALL OVER the place.

- Wear gloves that FIT (don't wear oversized gloves) when doing IV's, arterial blood gases, etc.

- Throw away your own sharps. Don't throw away other people's sharps unless otherwise communicated. The person who uses the sharp and puts it down should generally be responsible for throwing it away. (As a SICU med student, I spent a couple weeks throwing away sharps for a resident after all sorts of procedures -- I didn't complain when perhaps I should have, but I think asking someone else to throw away entire jumbled trayfuls of sharps you've used is not safe and not cool.)

- Assume EVERY patient has HIV, hep B and hep C. (This is hard -- I still don't, but I should.)

- Wear gloves when handling units of blood / plasma / etc. They're supposed to be clean, but it's still good habit to avoid skin contact with ALL bodily fluids (even screened "cleaned" specimens).

- Wear gloves when handling Foley bags and suction cannisters.

- If you have cuts/sores on your hands, one trick is to COVER THEM with a tegaderm. (Some people use a sterilely opened tegaderm if they need to glove sterilely -- ask about that if you're not sure if it's okay.)

Now that is one scary post I've just written. 🙄

 

[hotdocmitch]

Watch out for those crazy surgeons. They can be so careless with their needles in the OR. I was stuck by a jack*** resident in the OR when we were both closing on a lap chole. Of course the patient had Hep C but HIV neg. Thank God 6 mos later I'm hep c neg. Sometimes it's not enough to be careful about what you're doing with sharps but you have to be mindful of the other people around you.