contact with AIDS patient

[lazycat]

what will happen when you have to check a AIDS patient ? how do you feel ? are you still afraid and not confident when you have mask, hat, gloves...??? what will you do ? deny to check them or face to their condition ?

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[cpants]

what will happen when you have to check a AIDS patient ? how do you feel ? are you still afraid and not confident when you have mask, hat, gloves...??? what will you do ? deny to check them or face to their condition ?

Really? Maybe you need to do some research. With an HIV patient you do not really need any special precautions during examination. During blood draws and other procedures where you will come in contact with body fluids, personal protection is necessary. It just isn't that easy to catch HIV. You need direct contact of their body fluids with your body fluids.

If the patient has full blown AIDS, you will need to wear the additional equipment you described. However you are still extremely unlikely to contract HIV. The additional equipment is to defend you from the many opportunistic infections an AIDS patient harbors, and to defend the patient from the organisms on you, to which they are highly susceptible. You are much more likely to catch TB from an AIDS patient than HIV.

 

[runner1323]

what will happen when you have to check a AIDS patient ? how do you feel ? are you still afraid and not confident when you have mask, hat, gloves...??? what will you do ? deny to check them or face to their condition ?

I'm sorry, but this question is absolutely ridiculous. Seriously? Do you know how HIV is transmitted? Touching someone with AIDS will NOT transmit the virus. I have worked with numerous AIDS patients, including those in end-stage, and had absolutely NO ISSUE working with them.

I really hope, for your sake, that this question is in reference to "someone you know". We do not need people entering the medical profession who refuse to work with patients because of their condition. Seriously...this is just continuing the stigma that this country has been working hard to overcome for years (and that, unfortunately, many other countries still have to deal with).

I really hope this is just a troll...

 

[Law2Doc]

what will happen when you have to check a AIDS patient ? how do you feel ? are you still afraid and not confident when you have mask, hat, gloves...??? what will you do ? deny to check them or face to their condition ?

If you do a medicine, surgery or EM rotation at a hospital in a densely populated location, you will not only have to "check" people with HIV and even full blown AIDS on an almost daily basis, but as a med student will also have to do procedures (blood draws, rectal or pelvic exams, assist in operations) on them as well. This is a big part of medicine these days. You need to get over this. Obviously you use universal precautions and will try even harder to avoid needle sticks and scalpel nicks when you know a patient is HIV or HepC positive, but a sizeable portion of the people who have never been tested will have bloodborn illnesses as well. So you pretty much have to assume everyone you work on in med school is an HIV player and you will be right much of the time. These people are sick, at risk for lots of things, and need medical help, and so if you want to be a doctor, this is part of the patient base. Just as in Osler's time he was quoted to have said you had to be very familiar with syphilis to be a good doctor, these days you have to be intricately familiar with HIV.

There are far far more contagious things you will risk exposure to as a med student. Maybe not as life altering/deadly, but much more likely to "get" you. TB, c. diff jump to mind, but there are many others. These are things you will be on the front line exposure of as a med student, and the odds of contracting them while "checking" a patient are simply much greater. And there are enough antibiotic resistant strains these days that these illnesses can be a very big thing. So you use universal precautions, and be careful. But you have to deal with this, because you can't live in fear of treating patients or you cannot be a doctor. Plain and simple.

 

[Tiger26]

what will happen when you have to check a AIDS patient ? how do you feel ? are you still afraid and not confident when you have mask, hat, gloves...??? what will you do ? deny to check them or face to their condition ?

You know, they can pass it on to you just by looking at you kinda funny . . . . .

 

[Mr hawkings]

what will happen when you have to check a AIDS patient ? how do you feel ? are you still afraid and not confident when you have mask, hat, gloves...??? what will you do ? deny to check them or face to their condition ?

You are kidding. Right?
A physician/med student choosing to withold medical care because of a patient's health status. I'm sure that will go over just fine.

 

[Guyton Killah]

OMG! What a question! What kind of medicine student are you? N how old are you? Thats a vey lame question, buddy. Grow up .

 

[Mr hawkings]

I'm sorry, but this question is absolutely ridiculous. Seriously? Do you know how HIV is transmitted? Touching someone with AIDS will NOT transmit the virus. I have worked with numerous AIDS patients, including those in end-stage, and had absolutely NO ISSUE working with them.

I really hope, for your sake, that this question is in reference to "someone you know". We do not need people entering the medical profession who refuse to work with patients because of their condition. Seriously...this is just continuing the stigma that this country has been working hard to overcome for years (and that, unfortunately, many other countries still have to deal with).

I really hope this is just a troll...

From looking at her post history, it looks like the OP might be based in one of said countries. So this mightnot be a troll afterall.

 

[KeyzerSoze]

You are kidding. Right?
A physician/med student choosing to withold medical care because of a patient's health status. I'm sure that will go over just fine.

The OP happens to be wrong, because using proper precautions makes it relatively safe to treat infected patients. However, if it were actually a serious risk - hypothetically speaking - you are not ethically obligated to endanger your own life to treat a patient.

 

[atomi]

I'm sorry, but this question is absolutely ridiculous. Seriously? Do you know how HIV is transmitted? Touching someone with AIDS will NOT transmit the virus. I have worked with numerous AIDS patients, including those in end-stage, and had absolutely NO ISSUE working with them.

I really hope, for your sake, that this question is in reference to "someone you know". We do not need people entering the medical profession who refuse to work with patients because of their condition. Seriously...this is just continuing the stigma that this country has been working hard to overcome for years (and that, unfortunately, many other countries still have to deal with).

I really hope this is just a troll...

Plenty of doctors have an irrational phobia over HIV that they can't control. They want to help their patients, but are paralyzed by fear over the disease. Don't hate the guy because he has a phobia - that's not his fault. Phobia and prejudice are two different things.

 

[njbmd]

Plenty of doctors have an irrational phobia over HIV that they can't control. They want to help their patients, but are paralyzed by fear over the disease. Don't hate the guy because he has a phobia - that's not his fault. Phobia and prejudice are two different things.

Universal precautions for every pateint. A patient can be HIV negative today and HIV positive tomorrow. U-precautions for everyone.

 

[silas2642]

what will happen when you have to check a AIDS patient ? how do you feel ? are you still afraid and not confident when you have mask, hat, gloves...??? what will you do ? deny to check them or face to their condition ?

Seriously? Do you know how difficult it is to get HIV? BTW, it is ILLEGAL to not treat someone based on their medical condition, especially if they are HIV positive-- they are especially protected because they are a group who would be discriminated against unless they were protected. Like njbmd said, universal precautions for everyone, and if you have an open lesion yourself, cover it up with some tegiderm (sp?) to protect yourself and your patients (as advised to me by a preceptor)

 

[mjl1717]

Universal precautions for every pateint. A patient can be HIV negative today and HIV positive tomorrow. U-precautions for
everyone.

1)This is the bottom line ={universal precautions}

2) Also guys as said -I wouldnt blast the guy for a phobia..Prejudice is something else.. [eg. some may have phobia for oozing feces, roaches, purulent anaerobic infections,...But its best to desensitive a phobia..

3)As L2D said there are other more contagious diseases.. Hepatitis B also lives outside the body for a LONG time..

 

[45408]

Even with a direct needle stick, your chances of getting HIV - without taking any antiviral therapy or anything - is about 0.3%. You'd have to jab your finger about 100 times to even have a 1 in 3 shot at getting HIV.

Now, Hepatitis B is more like a 30% chance. That's what you should worry about.

 

[atomi]

Universal precautions for every pateint. A patient can be HIV negative today and HIV positive tomorrow. U-precautions for everyone.

Agreed. But there are plenty that have a psychologically recognized OCD-type phobia that is only present when knowing the patient has HIV or AIDS.

I think it is very good advice to assume every patient has HIV and if a exposure ever occurs with any patient to treat it as a potential HIV+ exposure.

 

[atomi]

Even with a direct needle stick, your chances of getting HIV - without taking any antiviral therapy or anything - is about 0.3%. You'd have to jab your finger about 100 times to even have a 1 in 3 shot at getting HIV.

Now, Hepatitis B is more like a 30% chance. That's what you should worry about.

Why is the risk of contracting HIV with a direct HIV+ needlestick so low? Does HIV not live in blood outside of the body? I mean, in the clinical setting, any needlestick is likely going to be with fresh blood - is that still a low risk? Does it have to do with the route of dermal infection being low (is it?)?

Regarding antiviral therapy, can that eliminate an infection at the early stage (obviously antiviral therapy is ineffective at a cure once the infection is established), but does that mean that antiviral therapy can 'cure' the disease at such an early stage? Or does it just prevent the virus from replicating enough to take over? This is something I would like to know more about. How infectious is HIV? Suppose a single live virus is injected into the bloodstream of an uninfected individual, is that single virus enough to start an infection, or will millions or virii be needed to establish an irreversible infection? Is the immune system able to handle 'small' infections on its own? Would this explain why the risk in a confirmed positive needlestick injury is so low?

Also, aren't most providers vaccinated against HepB - so this wouldn't be a concern? Did you mean HepC?

 

[Dirt]

Why is the risk of contracting HIV with a direct HIV+ needlestick so low? Does HIV not live in blood outside of the body? I mean, in the clinical setting, any needlestick is likely going to be with fresh blood - is that still a low risk? Does it have to do with the route of dermal infection being low (is it?)?

It has to the do with viral load present in a drop of blood, (low for the HIV and high for Hep B) and the inoculum size needed to cause infection (also low for HIV compared to Hep).

When you are dealing with a needle stick it is almost always going to be straight from someone's arm so HIV will still be alive. Hep B survives a lot longer, but if the stick is fresh "ex vivo" survivability doesn't really matter much.

 

[Blesbok]

Really? You guys have to see AIDS patients? Here in candyland we don't have that disease.

Seriously though, just wear gloves and a mask if there is any chance of blood contact. Otherwise just treat them like a normal patient. In surgeries you may choose to use blunt needles and you of course are going to be extra careful. At our school a lot of the attendings don't like to have students scrub on high risk cases like that just because they are more apt to make an error compared to someone who has dealt with it before and it isn't worth risking the students health just to watch a surgery that they could most likely see on a non-HIV patient.

 

[Blesbok]

It has to the do with viral load present in a drop of blood, (low for the HIV and high for Hep B) and the inoculum size needed to cause infection (also low for HIV compared to Hep).

When you are dealing with a needle stick it is almost always going to be straight from someone's arm so HIV will still be alive. Hep B survives a lot longer, but if the stick is fresh "ex vivo" survivability doesn't really matter much.

Interestingly, I read a report a while back that there has never been a documented case of medical personnel transmission through a suture needle, only though hollow bore needles.

 

[Bacchus]

Even with a direct needle stick, your chances of getting HIV - without taking any antiviral therapy or anything - is about 0.3%. You'd have to jab your finger about 100 times to even have a 1 in 3 shot at getting HIV.

Now, Hepatitis B is more like a 30% chance. That's what you should worry about.

Since you mentioned this I'm gonna piggyback on a question. I'm taking this upper level social science, AIDS and Society and we talked about occupational exposure. I asked the instructor of seroconversion cases he's aware of and he said he only knows of 2 because ARVs weren't given within the 72 hour window. Can you affirm this? I'd assume it would be this low, but don't know.

 

[45408]

Why is the risk of contracting HIV with a direct HIV+ needlestick so low? Does HIV not live in blood outside of the body? I mean, in the clinical setting, any needlestick is likely going to be with fresh blood - is that still a low risk? Does it have to do with the route of dermal infection being low (is it?)?

HIV isn't a very resilient virus, and it cannot live outside the body for more than a matter of minutes.

Suppose a single live virus is injected into the bloodstream of an uninfected individual, is that single virus enough to start an infection, or will millions or virii be needed to establish an irreversible infection? Is the immune system able to handle 'small' infections on its own? Would this explain why the risk in a confirmed positive needlestick injury is so low?

Feel free to volunteer for a study that would confirm this! I don't think anyone knows the specifics for viral particles required for seroconversion, but I'm sure some applicable animal models exist.

Also, aren't most providers vaccinated against HepB - so this wouldn't be a concern? Did you mean HepC?

I'm vaccinated against Hep B (and Hep A), but not all older adults are. And while Hep C is a more serious health concern (much higher risk of chronic infection), I think Hep B is more of an occupational risk than Hep C. I could have them switched though.

 

[sprinkibrio]

The OBs at our medical school don't like us to take on AIDS patients (and those with other blood transmissible diseases), because we take a very large part in the delivery. On other rotations this sure as hell doesn't apply or we would have no patients.

 

[atomi]

When you are dealing with a needle stick it is almost always going to be straight from someone's arm so HIV will still be alive.

But the claim was made that there was a 0.3% risk in a 'needlestick' injury. If the HIV is alive, why is the risk so low? Or was it meant that only 0.3% of needlestick injuries occurred with fresh blood?

And why are people so often infected through transfusions? If HIV didn't live outside the body as claimed, why would the Red Cross even bother with testing?

 

[bodonid]

Amen.

 

[Dirt]

But the claim was made that there was a 0.3% risk in a 'needlestick' injury. If the HIV is alive, why is the risk so low? Or was it meant that only 0.3% of needlestick injuries occurred with fresh blood?

And why are people so often infected through transfusions? If HIV didn't live outside the body as claimed, why would the Red Cross even bother with testing?

Read the top half of my post. I was taught the risk was between 0.5% and 1% for a fresh straight from the AIDS patient stick.

The risk of infection with a blood transfusion is far, far greater (I think around 75% but don't quote me), because of sheer volume. The amount of blood being exchanged with a transfusion is probably 3 or 4 orders of magnitude greater than with a needle stick. That equals a hell of a lot more virus being transferred.

 

[grandslam521]

Just in case anyone hasn't heard this before - we were taught the Rule of 3's for needle sticks

1/300 for HIV
1/30 for Hep C
1/3 for Hep B

This is the chance that you will be infected if you are stuck by a needle containing the respective virus.

 

[smq123]

The OBs at our medical school don't like us to take on AIDS patients (and those with other blood transmissible diseases), because we take a very large part in the delivery. On other rotations this sure as hell doesn't apply or we would have no patients.

That's kind of silly, I have to say.

The chances of you sticking yourself during a normal SVD is really low. And you wear a mask, sterile gloves, a sterile gown, eye covering, and plastic boots during SVDs anyway.

The only way you'd really stick yourself is if you assisted in cutting an episiotomy, assisted in repairing an espisiotomy, or assisting in a c-sxn. In any case, your risk of sticking yourself is MUCH higher in surgery or EM.

 

[panerai1]

SUNY school here, we are told not to participate in patient care that would provide high risk exposure to Hepatitis or HIV, mainly for the reason above (risk/benefit of injury vs. learning). That said, it's all out the window in the floors/OR, but adhered to for OB.

 

[atomi]

Read the top half of my post. I was taught the risk was between 0.5% and 1% for a fresh straight from the AIDS patient stick.

The risk of infection with a blood transfusion is far, far greater (I think around 75% but don't quote me), because of sheer volume. The amount of blood being exchanged with a transfusion is probably 3 or 4 orders of magnitude greater than with a needle stick. That equals a hell of a lot more virus being transferred.

My question is about the virus living outside of the body. I understand a direct blood transfusion, but in the case of blood that has been stored for months, does the virus continue to live in this blood? I don't understand.

 

[smq123]

My question is about the virus living outside of the body. I understand a direct blood transfusion, but in the case of blood that has been stored for months, does the virus continue to live in this blood? I don't understand.

The HIV virus is inactivated by exposure to open air (i.e. a drying effect). So if it is in blood that has been stored for a while, but away from open air, the virus can still survive.

 

[Dirt]

My question is about the virus living outside of the body. I understand a direct blood transfusion, but in the case of blood that has been stored for months, does the virus continue to live in this blood? I don't understand.

Yes it does. While blood stored for transfusion isn't technically "in" the body, and in-vitro changes do occur, it isn't technically out of the body either, it is sufficient to keep HIV virus alive and well because there are living cells for the HIV to exist/replicate in.

 

[lazycat]

thanks for all comment guys. your ideas about this entry are so useful and interesting!
to SILAS :
if we protect them, HIV positive patients, when we are contracted , who will protect us ? another kindly doctor ?!!!!
although it is a low risk to contract HIV when have Uni. precaution, but when we have a high risk HIV needle stick, what will you be? take an immediate blood test, take high dose ARV and still continue your life for 6 months later to next blood test with happily ??? or feeling all are a disaster???
i have a friend, he was last year student when he got a needle stick while working in ED.... he has have 6 moths in hell for waiting the last result. he was so stress to graduate ...
we all realize that we must be very very be careful , but if we are not fortunate enough ... what will we be ?
do you know how many doctors or medical personnels were contracted by dangerous infectious diseases per year ? how many of them were died or quit their jobs ?

 

[Law2Doc]

thanks for all comment guys. your ideas about this entry are so useful and interesting!
to SILAS :
if we protect them, HIV positive patients, when we are contracted , who will protect us ? another kindly doctor ?!!!!
although it is a low risk to contract HIV when have Uni. precaution, but when we have a high risk HIV needle stick, what will you be? take an immediate blood test, take high dose ARV and still continue your life for 6 months later to next blood test with happily ??? or feeling all are a disaster???
i have a friend, he was last year student when he got a needle stick while working in ED.... he has have 6 moths in hell for waiting the last result. he was so stress to graduate ...
we all realize that we must be very very be careful , but if we are not fortunate enough ... what will we be ?
do you know how many doctors or medical personnels were contracted by dangerous infectious diseases per year ? how many of them were died or quit their jobs ?

I don't know what answer you want. If you want to be a med student or physician, you will have to treat people who are HIV+, Hep+ or even have full blown AIDS. That's a big percentage of the patient base. And the percentage of people you will treat who have never been tested but probably have HIV is going to be even larger. So you be very careful. You use precautions. And if you get stuck, you follow the needlestick procedure/post exposure prophylaxis in effect in any hospital, and cross your fingers and be thankful that the odds of contracting a bloodborne illness is fairly low. Much higher if you work longterm in the ED or OR where you will get stuck/nicked not once but hundreds of times over the course of your career. That's a risk of the profession. You don't get to be a doctor only for healthy safe people.

In terms of numbers, from a quick google search, it appears from the AVERT website that:
"Up until December 2006, health care workers in the USA reported 57 occupational HIV infections. Of these, 48 had percutaneous exposure; 5, mucocutaneous exposure; 2, both percutaneous and mucocutaneous exposure; and 2, an unknown route of exposure. In addition, 140 possible occupational transmissions have occurred among healthcare personnel. These are cases in which a worker is infected with HIV and has a history of occupational exposure, but did not have a test immediately before and after the possible exposure. As no other risk factors are reported, it is most likely that the infection has occurred as a result of that occupational exposure."

So that's really not a big percentage, given the number of healthcare workers, of which doctors are only a small percentage. It doesn't say how many deaths, but these days thanks to good meds, individuals with HIV can often live near normal lifespans with the virus.

 

[Blesbok]

I don't know what answer you want. If you want to be a med student or physician, you will have to treat people who are HIV+, Hep+ or even have full blown AIDS. That's a big percentage of the patient base. And the percentage of people you will treat who have never been tested but probably have HIV is going to be even larger. So you be very careful. You use precautions. And if you get stuck, you follow the needlestick procedure/post exposure prophylaxis in effect in any hospital, and cross your fingers and be thankful that the odds of contracting a bloodborne illness is fairly low. Much higher if you work longterm in the ED or OR where you will get stuck/nicked not once but hundreds of times over the course of your career. That's a risk of the profession. You don't get to be a doctor only for healthy safe people.

In terms of numbers, from a quick google search, it appears from the AVERT website that:
"Up until December 2006, health care workers in the USA reported 57 occupational HIV infections. Of these, 48 had percutaneous exposure; 5, mucocutaneous exposure; 2, both percutaneous and mucocutaneous exposure; and 2, an unknown route of exposure. In addition, 140 possible occupational transmissions have occurred among healthcare personnel. These are cases in which a worker is infected with HIV and has a history of occupational exposure, but did not have a test immediately before and after the possible exposure. As no other risk factors are reported, it is most likely that the infection has occurred as a result of that occupational exposure."

So that's really not a big percentage, given the number of healthcare workers, of which doctors are only a small percentage. It doesn't say how many deaths, but these days thanks to good meds, individuals with HIV can often live near normal lifespans with the virus.

Considering there are somewhere between 600-800k needlesticks per year that is pretty damn low...

 

[atomi]

Yes it does. While blood stored for transfusion isn't technically "in" the body, and in-vitro changes do occur, it isn't technically out of the body either, it is sufficient to keep HIV virus alive and well because there are living cells for the HIV to exist/replicate in.

So say an infected drug user leaves a tainted syringe on the beach and a day later a passerby steps on it (this actually happened to someone I know). Would the blood inside the bore of the needle have dried out? Would there have been any chance that the person could have been infected? He turned out fine, and I'm not sure if they made him do AVT or not, but he did have to go in for weekly tests for 6 months.

 

[atomi]

Considering there are somewhere between 600-800k needlesticks per year that is pretty damn low...

Although from 1990, this is a bit scary:

http://www.aegis.com/aidsline/1990/nov/M90B0579.html

21% of 3rd and 4th year students at Cornell reported having been stuck by an HIV infected needle.

 

[atomi]

So say an infected drug user leaves a tainted syringe on the beach and a day later a passerby steps on it (this actually happened to someone I know). Would the blood inside the bore of the needle have dried out? Would there have been any chance that the person could have been infected? He turned out fine, and I'm not sure if they made him do AVT or not, but he did have to go in for weekly tests for 6 months.

Think I found my own answer. HIV can live in a syringe for up to 6 weeks

...
http://depts.washington.edu/hivaids/post/case1/discussion.html

 

[meister]

Although from 1990, this is a bit scary:

http://www.aegis.com/aidsline/1990/nov/M90B0579.html

21% of 3rd and 4th year students at Cornell reported having been stuck by an HIV infected needle.

That is a generation ago, I wouldn't trust that survey to reflect anything at all about our current environment.

 

[atomi]

That is a generation ago, I wouldn't trust that survey to reflect anything at all about our current environment.

That's what I thought, but we're talking about needlesticks here. Unless med students are no longer handling needles, I assume fumbles are going to happen occasionally.

And I don't know about L2D's assertion that surgeons will incur hundreds of exposures in their career. Nobody would go into the field if that were true. Aren't there gloves that can protect against sticks and cuts?

 

[Law2Doc]

...
And I don't know about L2D's assertion that surgeons will incur hundreds of exposures in their career. Nobody would go into the field if that were true. Aren't there gloves that can protect against sticks and cuts?

I know many surgeons and they all say nicks are simply a part of the landscape. If you look at stats of nicks/sticks, surgeons always top the list. And even on your surgery rotation you will notice that they often will have to change gloves multiple times during long procedures because they break/get cut up.

 

[Danbo1957]

A physician needs to be aware that any person to be treated may have HIV or AIDS - or ANY OTHER INFECTIOUS DISEASE. Period.

Risk of infection rates mean nothing when it concerns your health and well-being.

As you move forward in your training you will learn the standards and protocols for patient treatment concerning HIV and AIDS...

 

[Law2Doc]

A physician needs to be aware that any person to be treated may have HIV or AIDS - or ANY OTHER INFECTIOUS DISEASE. Period.

Risk of infection rates mean nothing when it concerns your health and well-being.

As you move forward in your training you will learn the standards and protocols for patient treatment concerning HIV and AIDS...

I understand what you are saying when you say the rates mean nothing when it comes to your own health and well being. But that being said, you can't say "no thanks" when presented with a patient who has AIDS. So you follow the standards/protocols, but push on. You don't get to play it safe by only working with disease free people if you are going to be a doctor (or even a med student). At some level you will be putting yourself at a risk, minimized as best it can be. So yes, infection rates can and do give you some solace, given that you have to use sharp objects and break skin of folks with bloodborne illnesses on a regular basis. No sane person would do a job without knowledge of the risks involved.

 

[smq123]

Plenty of doctors have an irrational phobia over HIV that they can't control. They want to help their patients, but are paralyzed by fear over the disease. Don't hate the guy because he has a phobia - that's not his fault. Phobia and prejudice are two different things.

Really? "Plenty of doctors have an irrational phobia over HIV"? Where are you getting that piece of information?

If you really have a phobia over HIV, then you shouldn't be a healthcare worker. It's very simple. I cannot think of a specialty where you can avoid HIV patients altogether (besides radiology...and even radiologists must do an internship!). If you're that afraid of HIV, then don't put yourself in the position where you must take care of HIV+ patients.

There are plenty of frightening transmittable "stuff" in medicine besides just HIV, by the way. Tuberculosis, Hep C, lice, scabies, MRSA, C. difficile...the list goes on.

That's what I thought, but we're talking about needlesticks here. Unless med students are no longer handling needles, I assume fumbles are going to happen occasionally.

And I don't know about L2D's assertion that surgeons will incur hundreds of exposures in their career. Nobody would go into the field if that were true. Aren't there gloves that can protect against sticks and cuts?

No, there are no impenetrable gloves. You need to be careful and aware of where your needles are.

21%, though, is much too high. That number is outdated. Universal precautions were not a big deal until the late 1990s - now, all med students are aware of universal precautions. IV needles are also different now, with a protective cap over them that you can flip up once you're done.

 

[45408]

No, there are no impenetrable gloves. You need to be careful and aware of where your needles are.

I wore my chainmail gloves in the OR, and the attendings didn't seem to mind. You just have to wear at least a size 9 glove to fit over them though.

 

[SouthernSurgeon]

Our school also has a "students don't have to participate in invasive procedures on high risk patients" policy...but it's pretty loosely enforced.

As to the surgeon thing - I've seen so many nicks/dinga during my rotation...I'm surprised surgeons still have all their fingers by the end of their careers! Though if I had to choose, I'd take a bovie injury - hurts like hell, but the cautery probably helps mimimize risk.

Gloves aren't really meant to stop a needle from penetrating, btw...what they do do is reduce the volume of fluids on the needle (and this the infectious load). I can personally attest that an 18 gauge has no trouble going through two pairs of orthos

 

[sprinkibrio]

Really? "Plenty of doctors have an irrational phobia over HIV"? Where are you getting that piece of information?

I don't find this so surprising. Sometimes knowledge won't set you free, it will make you realize how lucky you are for being healthy and how much you want to stay that way. Anyways, I'm sure it applies to a lot of the doctors trained before the 90s.

 

[Law2Doc]

Our school also has a "students don't have to participate in invasive procedures on high risk patients" policy...but it's pretty loosely enforced.
...

Most schools fortunately don't have this kind of policy -- if you go to school in a dense population center, a huge percentage of your patients are either HIV or Hep positive, or simply haven't been tested yet (but have multiple risk factors). You'd be standing around outside of the OR the whole rotation, waiting for that rare low risk patient.

 

[smq123]

Anyways, I'm sure it applies to a lot of the doctors trained before the 90s.

I'm not convinced. Seeing how many "old school" doctors that I have seen who have a blatant and frightening disregard for universal precautions, they seem LESS fearless than the residents are.

 

[45408]

Most schools fortunately don't have this kind of policy -- if you go to school in a dense population center, a huge percentage of your patients are either HIV or Hep positive, or simply haven't been tested yet (but have multiple risk factors). You'd be standing around outside of the OR the whole rotation, waiting for that rare low risk patient.

I did trauma surgery in a hospital surrounded by a fairly high-risk population, and I don't think we had anyone with HIV. I only had one HIV+ patient when I did EM at the same hospital, and one Hep C patient. It's not quite as common as you make it sound. You wouldn't be "standing around waiting for a low-risk patient."

 

[Law2Doc]

I did trauma surgery in a hospital surrounded by a fairly high-risk population, and I don't think we had anyone with HIV. I only had one HIV+ patient when I did EM at the same hospital, and one Hep C patient. It's not quite as common as you make it sound. You wouldn't be "standing around waiting for a low-risk patient."

I guess it depends on the place then. Suffice it to say that at some places you can flip the ratio.