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Contraction of HIV, Hepatitis, etc. from "needle pricks"

Discussion in 'Pre-Medical - MD' started by DZT, Mar 28, 2002.

  1. DZT

    DZT Senior Member
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    Hey y'all, I've always had an interest in surgery and it just occurred to me how much at risk surgeons, and medical doctors are of contracting HIV and Hepatitis from needle pricks. Though an adept surgeon should not be routinely getting stuck with needles, there is a slight possibility. Currently, I am shadowing a general surgeon and he contracted Hepatitis B after a needle prick. Fortunately, his case of hepatitis has not been deleterious to his health (or he would not be operating). Yet, if the patient had HIV, then it would be a completely different story. As a physician, it will not only be my legal duty, but my moral duty to help whoever needs medical treatment. I say to myself now that I will unconditionally operate on an AIDS patient (or some other blood based disearse), but when the situation arises, I don't know what types of qualms will arise. Eventually, I know I will do my duty, but heck if I prick my finger, then its game over for me as well.

    Any thoughts?
     
  2. Diogenes

    Diogenes Succat
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    I've got a thought.

    I think that nurses are more at risk for needle sticks than doctors.
     
  3. DZT

    DZT Senior Member
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    I'm sorry if I forgot to acknowledge nurses, but considering that this is preallopathic, I'm adressing future physicians in this topic.
     
  4. mdhopeful

    mdhopeful Senior Member
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    you should try and take a look at some hospital infection control material as well as some infectious diseases stuff. if you take the hep b series, you should not have to worry. as for hiv, the number of viral particles per drop of blood is several hundred times less than for hep b particles. in the general population, the hiv prevalence is less than half a percent, so the likelihood of contracting hiv from a needle prick is almost zero. of course, there are stories of it happening, but for it to happen a lot of things would have to occur in the chain of events, such as the person being infected, there being enough virions on the needle, the blood actually making it into your system (usually it gets lost through the gloves or clothing on the way in), and the dose to actually be enough of a inoculum. another thing to consider is that post-exposure prophlaxis is very effective. if you think you got pricked and find out the patient has hiv you take intensive azt therapy for a short period to avoid infection. these are standard procedures and precautions that most health personnel take.
     
  5. Diogenes

    Diogenes Succat
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by nb81:
    <strong>I'm sorry if I forgot to acknowledge nurses, but considering that this is preallopathic, I'm adressing future physicians in this topic.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">My point wasn't to give props to nurses or anything. My point was to, in a sideways kind of way, tell you that you shouldn't waste your time worrying about this now.
     
  6. SarahL

    SarahL Senior Member
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    Hi...I used to volunteer on an AIDS hotline and also did clinical research on HIV before applying to med school.

    Contracting HIV from needle sticks is extremely rare, even among nurses. Post-exposure prophylaxis involves taking protease inhibitors for about a month. It's very unpleasant, but very effective.

    The hepatitis B vaccine is also very effective. If you've been vaccinated, your chances of getting it after a needle stick are quite low.
     
  7. Diogenes

    Diogenes Succat
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by SarahL:
    <strong>The hepatitis B vaccine is also very effective. If you've been vaccinated, your chances of getting it after a needle stick are quite low.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Yeah, and OSHA requires that all person that work in an environment where blood-borne pathogens are a threat get a Hep B vaccination. I work for a pharmaceutical company and I encounter human blood (in tha lab) less than once a month yet I had to get vaccinated for Hep B. I'm virtually certain that Hep B is on the list of required vaccinations for med schools. Given the vaccine's effectiveness, do as I said before and don't waste your time worrying about it, especially now.
     
  8. oldman

    oldman Senior Citizen
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    I'd worry more about hepatitis than HIV. Hepatitis can live outside of the body for weeks. I was drawing blood from a patient who was jaundiced. I got a big drop of it on my scrubs...guess where those scrubs went? not home with me! I was sort of pissed cause they were my own scrubs. Now I only wear the ones from the hospital cause I'll be damned if I have to buy more scrubs.
     
  9. Scooby Doo

    Scooby Doo IEatShavedPussyCats
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by nb81:
    <strong>Though an adept surgeon should not be routinely getting stuck with needles, there is a slight possibility. </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Nice try...no matter how adept you are you can still be getting pricked anytime. I shadowed the chief orthopedic surgeon at a hospital and he had been stuck almost a dozen times since he started working there. He had just gotten his tests back and they were all negative. This was one of the topics of discussion between everyone in the room during one ACL surgery.
    You can't say that just b/c you are good you won't get stuck. That's like saying b/c you are a good driver, you won't get in a car accident...doesn't work that way...
     
  10. oldman

    oldman Senior Citizen
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    I don't think surgeons are as likely to get stuck by a needle. More likely they will get a cut from a scalpel. Unfortunately, the nurses (IV starters) and us phlebotomists (needle guys) are at a higher risk for sticks.

    They have nice safety designs for needles these days.

    For the IV needles, they have a spring powered retracter. For the straight needles and butterflies I use, they have flip and sliding guards.
     
  11. Diogenes

    Diogenes Succat
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Scooby Doo:
    <strong>You can't say that just b/c you are good you won't get stuck. That's like saying b/c you are a good driver, you won't get in a car accident...doesn't work that way...</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I totally agree with this analogy, but could you extend it and say that there are certain places that are safer to drive through than others? Are some hospitals/clinics more aware of neddle sticks in general than others? I was in the ER of San Francisco General, and everyone there was super-aware of needle-stick prevention. But I've seen other hospitals were the staff seemed somewhat less cautious/paranoid.
     
  12. oldman

    oldman Senior Citizen
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    anesthsiologists, on the other hand, do sticks fairly often. so they have a greater chance of getting needle sticks. nurse anesthetists are also likely to have this happened. i've had to draw blood from them (to test for blood borne pathogens) when there were accidents in the OR.
     
  13. Whisker Barrel Cortex

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    Surgeons often get stuck by needles because they do a lot of suturing during most operations. Scalpel sticks are relatively rare since they are bigger and easier to avoid. It is not Hep B that I would be worried about but Hep C. This is the virus that survives the longest outside the body and has no vaccine. Up to 85% of people with Hep C will develop chonic hepatitis. 20% of those people will develop cirrhosis, 50% of those will die from this. Their risk of Hepatocellular carcinoma is increased greatly as well. In contrast, of people infected with Hep B, only 4% will have chronic infection and less than half of those will develop cirrhosis.

    As for HIV transmission, the risk from needle sticks is VERY low. If prophylactic treatment is given after the treatment, the rate is almost zero.
     
  14. oldman

    oldman Senior Citizen
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    since they use forceps to hold the needle, i hope they don't stuck too often. i suppose there are times when someone will be jamming their hand into the area to push some piece of tissue out of the way, etc. I'm thinking that's when they get stuck.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Whisker Barrel Cortex:
    <strong>Surgeons often get stuck by needles because they do a lot of suturing during most operations. Scalpel sticks are relatively rare since they are bigger and easier to avoid. It is not Hep B that I would be worried about but Hep C. This is the virus that survives the longest outside the body and has no vaccine. Up to 85% of people with Hep C will develop chonic hepatitis. 20% of those people will develop cirrhosis, 50% of those will die from this. Their risk of Hepatocellular carcinoma is increased greatly as well. In contrast, of people infected with Hep B, only 4% will have chronic infection and less than half of those will develop cirrhosis.

    As for HIV transmission, the risk from needle sticks is VERY low. If prophylactic treatment is given after the treatment, the rate is almost zero.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">
     
  15. none

    none 1K Member
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    I got a tour of an HIV lab during one of my interviews and got a chance to read the post-exposure guidelines. There are many interesting anti-viral injections out there that reduce the risk of transmission to nearly 0 if taken very soon after a stick. I really don't think it should be much of a concern for an aspiring doctor, just something to remind you to be safe in the future. And I definitely second the nurses and phlebotomists being much, much more at risk.
     
  16. oldman

    oldman Senior Citizen
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    i almost got stuck once. i was withdrawing the butterfly and simultaneously applying a 2x2 to the site. at the moment the patient decided to move and the needle brushed against my skin. i was thinking that's a close one.
     
  17. oldman

    oldman Senior Citizen
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    my mom got stuck in the abdomen while she was carrying me. luckily nothing was transmitted.
     
  18. Scooby Doo

    Scooby Doo IEatShavedPussyCats
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    Yea...oldman,

    Look at your post number...

    The only thing that got transmitted was SATAN!!!

    haha

    j/k :)
     
  19. C U in MD school

    C U in MD school Senior Member
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    As a health care worker, I have had a needle stick before. To make the story short, I was drawing blood. The previous posts have done a great job at describing the statistics behind contraction of HIV and hep c, but I don't think you guys really understand what goes through your mind when it happens and how it effects your life and the life of your love ones. I ended up taking antiviral for a month, that was hell. Then came the fear of not knowing if I have HIV of hepc for 6 months post exposure. Although my risk of contracting HIV/ hepc was low, I still couldn't help to think what if. Everyday I thought about life, how I was going to tell my parents if I caught something or if I was still gonna go into medicine. It was very scary.

    As far as surgeons go, when I went to occupational health to get treatment, the nurse told me that surgeons get exposed all the time. As a matter of fact, they get exposed so much that they just stop coming to occupational health and every 6 months they order lab test for themselves. I have always wanted to be a surgeon, but I just don't think that I can live my life like that. Sure I want to help people, but I also want to live, raise a family, see my children grow and experience all the sorrows and joys of long and healthy life.
     
  20. oldman

    oldman Senior Citizen
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Scooby Doo:
    <strong>Yea...oldman,

    Look at your post number...

    The only thing that got transmitted was SATAN!!!

    haha

    j/k :) </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">yeah, i saw that! so i posted a bunch of extra times to get past the evil hump!
     
  21. oldman

    oldman Senior Citizen
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    funny thing about this thread..(i'm at work now). i just drew a nurse's blood cause she accidently got stuck. anytime you get stuck it's going to be a nerve racking thing mentally.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by C U in MD school:
    <strong>As a health care worker, I have had a needle stick before. To make the story short, I was drawing blood. The previous posts have done a great job at describing the statistics behind contraction of HIV and hep c, but I don't think you guys really understand what goes through your mind when it happens and how it effects your life and the life of your love ones. I ended up taking antiviral for a month, that was hell. Then came the fear of not knowing if I have HIV of hepc for 6 months post exposure. Although my risk of contracting HIV/ hepc was low, I still couldn't help to think what if. Everyday I thought about life, how I was going to tell my parents if I caught something or if I was still gonna go into medicine. It was very scary.

    As far as surgeons go, when I went to occupational health to get treatment, the nurse told me that surgeons get exposed all the time. As a matter of fact, they get exposed so much that they just stop coming to occupational health and every 6 months they order lab test for themselves. I have always wanted to be a surgeon, but I just don't think that I can live my life like that. Sure I want to help people, but I also want to live, raise a family, see my children grow and experience all the sorrows and joys of long and healthy life.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">
     

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