Craziest HIV related interview question EVER

[gary5]

You cup your hand like a tube and do mouth-to-hand-to-mouth, thus saving the patient without contracting HIV. Solved.

---

Members don't see this ad.

 

[Funky]

 

[DropkickMurphy]

You cup your hand like a tube and do mouth-to-hand-to-mouth, thus saving the patient without contracting HIV. Solved.

Or:

 

[gary5]

I smell troll.

I love the bear slide of your avatar. LOL!

 

[DoctaJay]

Ok so for whatever reason the HIV topic is sure blowing up in these past two days or so, which reminded me of a question that a friend got while interviewing at a DO school last year (I do not remember which one)...

So, lets say you are a doctor in a small town. You are walking down the street and you see that a patient of yours appears to have passed out or something and you asses that they need mouth to mouth (dont ask me why, i dunno). You also recognize your patient as being HIV+. In addition (i kid you not) you have just come from the dentist, where you had a tooth pulled, thus you have an open wound in your mouth. Now, you have exactly two minutes to act, you dont have your medical tools (mouth barrier, etc), and you cannot get anyone else to help you, because there is no one around.

what do you do?

when i heard this question, i got so scared about interviewing... luckily i never ran into anything nearly as crazy

I would either let the guy die, or try to instruct someone else to do what I was planning to do. You have to look at it this way...1) you save 1 person's life, and you possible contract a potentially deadly virus 2) you don't save his life, but you don't needlessly endanger you life and you live to save hundreds of lives. I'll take option #2.

 

[gary5]

The question is a trap. In an interview, you should choose the more altruistic option, which means that you risk your health to help the patient. In real life, you have a right to preserve your own well-being while helping the patient. However, this question denies you that right. Hence, it is a trap.

 

[DropkickMurphy]

 

[spicedmanna]

I would either let the guy die, or try to instruct someone else to do what I was planning to do. You have to look at it this way...1) you save 1 person's life, and you possible contract a potentially deadly virus 2) you don't save his life, but you don't needlessly endanger you life and you live to save hundreds of lives. I'll take option #2.

Ha. If the patient in the scenario is in full arrest, he's probably already dead. As to your other point, the act of caring for any patient likely places you in some kind of risk; quite simply, you do your best to minimize the risk associated. The nature of the job has risks (granted, some specialties have almost no risk of this nature). Your safety is definitely of primary importance, but if the risk is minimal (per your own judgment and by comparing with a standard), then acting would be indicated, if you have a duty to act. If you think there is significant risk of contracting HIV beyond the baseline rate of zero (no documented cases), then you can start performing chest compressions since you witnessed the arrest, skipping mouth-to-mouth, but making sure to make the airway patent. As long as you can defend what you did as the appropriate standard of care for this patient, and that there were significant risks to your own safety, if asked, you'll be fine, I would think.

 

[Anjlprincezz]

Well myne is cinda krazy.

Dureeng the mittle of meye interview:

Interviewer: (puts hand out to shake it)
Me: (shakes his hand)
Interviewer: Oh did I mention I have aids...
Me: ehhh (yanks hand back to body)....

Eye douhnt plan on getting acceptance thair.

You wouldn't get HIV from shaking hands with someone unless you both had open bleeding cuts and decided to swap some fluids.. Why would you shake somene's hand in the mittle of an interview?

The interviewer probably just wanted to gauge your rxn. There might be other reasons why you shouldn't plan on getting an acceptance thair...

 

[Anjlprincezz]

Sorry, i forgot about not feeding the trolls

 

[spicedmanna]

Sorry, i forgot about not feeding the trolls

Happens to the best of us.

 

[Anjlprincezz]

Legally I think it would be ok if you didn't act, since your own safety is primary.. Even if the risk is negligible, its not zero so you can't be legally bound to provide mouth to mouth, but I think compressions and a call to 911 are in order... also would it be helpful to use something like your t-shirt as a barrier? I would honestly try my best b/c I wouldn't want to lose a pt even if there were no legal repercussions...


Really ironic b/c I was just reading over legal and ethical obligations for the NREMT-B

 

[DropkickMurphy]

Happens to the best of us.

Probably 40% of my posts are dedicated to it.

 

[DropkickMurphy]

Legally I think it would be ok if you didn't act, since your own safety is primary.. Even if the risk is negligible, its not zero so you can't be legally bound to provide mouth to mouth, but I think compressions and a call to 911 are in order... also would it be helpful to use something like your t-shirt as a barrier? I would honestly try my best b/c I wouldn't want to lose a pt even if there were no legal repercussions...


Really ironic b/c I was just reading over legal and ethical obligations for the NREMT-B

So far as I'm aware (according to an article by a lawyer in an EMS magazine a couple of years back), only three or four states legally obligate off duty EMS providers to do anything more than a layperson would be required to do. I believe Minnesota is one.....I am not certain about the rest though.

 

[spicedmanna]

also would it be helpful to use something like your t-shirt as a barrier?

I think that this would be unlikely to be of benefit, except to peace-of-mind.

I would honestly try my best b/c I wouldn't want to lose a pt even if there were no legal repercussions...

Yeah, ethical and legal matters can be distinct. Basically proceed with caution, do what you can.

 

[DropkickMurphy]

I think that this would be unlikely to be of benefit, except to peace-of-mind.



Yeah, ethical and legal matters can be distinct. Basically proceed with caution, do what you can.

My ethics dictate: "Risk a lot to save a lot, risk a little to save a little, risk nothing to save that which is already lost".

 

[Anjlprincezz]

My ethics dictate: "Risk a lot to save a lot, risk a little to save a little, risk nothing to save that which is already lost".

I guess if you were to and contract HIV, you would put ur family ur patients and everyone you come into contact with at risk.. maybe its better to just leave well enough alone..

 

[DropkickMurphy]

I guess if you were to and contract HIV, you would put ur family ur patients and everyone you come into contact with at risk.. maybe its better to just leave well enough alone..

You wouldn't really put your patients at that much risk if you were positive. I'd just like to be around to see my kids grow up that's all. If I have to refrain from intervening to increase the probability of that happening because of an unacceptable risk to myself, then so be it.

 

[spicedmanna]

I guess if you were to and contract HIV, you would put ur family ur patients and everyone you come into contact with at risk.. maybe its better to just leave well enough alone..

Well, in this artificial scenario, who knows? In real life, yeah, I think most people would skip mouth-to-mouth. Anyway, the patient is in full arrest presumably, so there probably isn't much you can do without advanced ACLS equipment and meds, and/or an AED. CPR just keeps the blood pumping in most instances (spontaneous revival is rare) until definitive care can be given, increasing the efficacy of the definitive treatment and making sure the patient doesn't go into brain death until then. In this case, chest compressions without mouth-to-mouth is probably okay, anyway, given that you witnessed the arrest and the blood is still somewhat oxygenated. However, your prospects are grim given that the scenario indicates that there is noone around. Your patient is good as toast unless you can get him to an ER in a timely manner. So all your work will be for naught.

 

[DropkickMurphy]

our patient is good as toast unless you can get him to an ER.

Actually a lot of studies have shown that if a patient fails to have ROSC in the field with full ACLS intervention, further resuscitation in the ED is pointless for most codes. But you're right.....he's toast.

 

[Anjlprincezz]

ok im bored.. new, totally-unrealistic scenario anyone?

 

[spicedmanna]

Actually a lot of studies have shown that if a patient fails to have ROSC in the field with full ACLS intervention, further resuscitation in the ED is pointless for most codes. But you're right.....he's toast.

Thanks for the clarification. Right on.

 

[ExtremeUnderdog]

.