Freaking Out from an Exposure - advice needed

[juddson]

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My wife and three year old son and I went to the OB/GYN's office today for our first pregancy checkup. While the doctor was examining my wife, my three year old went over to the medical waste can, and finding the foot pedal curious, he stepped on it. When the lid popped open, it startled him and somehow he bumped into it or hit it or something. Anyway, he recieved two small cust on his hand from the can. They looked like two small paper cuts.

This was a typical stainless steel medical hazardous waste can with a red waste bag inside. None of us could tell on what part of the can he cut himself, as he and the can are shorter than the examination table, and all of us were on the other side of it. My guess is that he cut himself on the sharp edge of the lid, but we simply didn't see exactly what happened.

We cleaned the cuts with regular hand soap and then with purell (which burned and made him cry), but my wife and I are still freaking out.

Should we be worried at all, and if so, about what? It was a 4:00 pm appointment, so the can was pretty full of waste by then.

I've tried to console myself with the following:

He cut himself on the lid, not on a syringe, for instance. The can is stainless steel. Presumably nothing could live on that for very long, right? The odds that anything was actually on the part of the lid or can that he cut himself on are pretty small. And, even if, god forbit, our 3 year old was infected with anything, there are many many more types of innocuous things to be infected with than absolutely horrible things, right (like Hep C, HIV, etc.)?

Anyway, we are still freaking out and don't know what to do. Should we be doing something?

I'm posting this on a few forums so as to get good coverage.

Judd

 

[southerndoc]

Did he even come into contact with bloody products at all?

Chances are slim he contracted anything... very slim. However, you can have your pediatrician check if you want.

If your son had stuck himself with a dirty needle from an HIV+ patient, he would have a 1 in 300 chance of contracting HIV. Hepatitis B and C are much more infectious, but it's doubtful your son came into contact with blood contaminated with either.

You should talk to your son's pediatrician about it.

 

[ckent]

unless you go to an inner city ob/gyn, he probably doesn't even have any hep b, c or hiv patients to begin with. hiv cannot survive in dried blood too (don't know about hep b and c), so you really don't have to worry about that unless it was a dirty recent needle that he cut himself on. if i were you, i'd just make sure that his tetanus was up to date. if it is, then just forget about the whole incident. it really isn't worth investigating from the scenario that you described. Also, next time, lay off of the purrell. studies haven't shown anything to be more efficacious then soap and water. you can put some bacitracin over the cut too if you are worried about a lot of bacteria in the area. chances are though, the cuts have already healed, and that they were too superficial for anything (if anything was even present) to be transmitted. it's like taking a very low percentage of a very low percentage of a very low probability. if it was just the trash can, I'd worry more about getting in a car accident on your next drive out then this to be honest.

 

[DrDre']

I've read the risks for HIV are 3/1000, Heb B 3/100.

HIV, I believe, can only live 15 minutes outside the body, while I read Hep B can live an ungodly 6 weeks, supposedly. All of the above responses are likely accurate. It is very scary but the odds are even better than the above. I believe those are for arterial/venous inonculation with a hollow needle!

I had a high-risk junkie needle jabbed in my finger as a paramedic. She was Hep C pos. I was scared but fine.


As Ckent said, if you are too concerned about it, you may wreck your car- much more likely than seroconversion...

 

[ckent]

hep b is 30% with an open needle if you aren't immunized (which most kids are these days), and hep C is 3%. hiv is 0.3%. this is all dependent on the needle being open bore (never been a case of hiv transmission from a suturing or closed bore needle), and the amount of blood and gauge of the needle.

 

[juddson]

Thank you all so much for the replys. From what I gather, we have nothing to worry about. We are not talking about a needle stick. This seems to be very small superficial cuts from the lid to the garbage can. I spoke to a doctor last night and he said that it was hardly anything to worry about at all. We were freaking out last night, but things seem much clearer in the light of day.

We'll have him checked next time he is at the pediatrician, but other than that, our wrry is minimal thanks to you guys.

Thanks again

Judd

 

[doctormontero]

ckent....

Inner-city Ob/Gyn offices are NOT the only place you will encounter patients with HIV, Hep B, Hep C or any other infectious diseases. I certainly hope you have noticed that anyone, despite their race, age or class can be infected with almost anything imaginable. I hope your statement was a simple slip-up.

 

[BellKicker]

Why would there be blood in an open trashcan, anyway? Don't all docs put syringes/bloody cottonballs/anything else bloody in a special canister? One that doesn't (and shouldn't) open?

If the doctor really has potentially infectious material in an open container on the floor, then there's something wrong.

Juddson, at the very least, you should blame your doctor and not your son for this mishap.

 

[Sessamoid]

Originally posted by BellKicker
Why would there be blood in an open trashcan, anyway? Don't all docs put syringes/bloody cottonballs/anything else bloody in a special canister? One that doesn't (and shouldn't) open?

If the doctor really has potentially infectious material in an open container on the floor, then there's something wrong.

Read the OP. It wasn't an "open trashcan". It was apparently a closed trashcan with a pedal-activated lid. The kid stepped on it out of curiosity, which I consider normal behavior for small children. The can was the typical red-plastic-lined biohazard trash bag found in practically every medical exam room in the US. That's where potentially infectious material is supposed to go.

Juddson, at the very least, you should blame your doctor and not your son for this mishap.

Maybe you should be more educated before pointing fingers. People should be less centered on blaming people and just realize that sometimes **** just happens.

 

[doc05]

Why exactly did you bring your 3-year-old son into the exam room for your wife's GYN exam?

 

[Sessamoid]

Originally posted by doc05
Why exactly did you bring your 3-year-old son into the exam room for your wife's GYN exam?

If it was just a pregnancy checkup, there probably was no pelvic exam I'm guessing. Maybe just a fundal height, blah blah blah. All that stuff I've forgotten since my Ob rotation ages ago.

 

[BellKicker]

Originally posted by Sessamoid
The can was the typical red-plastic-lined biohazard trash bag found in practically every medical exam room in the US. That's where potentially infectious material is supposed to go.

Maybe you should be more educated before pointing fingers. People should be less centered on blaming people and just realize that sometimes **** just happens.

I'm talking about the little yellow absolutely closed containers for syringes. You know, the "contaminated sharps" bin. No one in their right mind would put a syringe in an open trash can on the floor (or rather, a trashcan that's fully open at certain moments). Come to think about it, you would never, ever put a syringe into any kind of bag be it red or any other color. In fact, I'm fairly certain the doctor in question didn't do that, either, but the original post mentions nothing about that.

With regards to other waste, yes, you're right. I was too fast on the gun there. A bloody cotton ball might end up in a trash can on the floor but I still believe such can should be kept out of reach of small children. No, I don't believe it should. It must be kept out of reach of children. Period.

I'm not blaming anyone, man. I'm just imagining if this happened to my kids and how scared I'd be. I've seen my 2-year old on the prowl in the doctor's office; she'll touch anything in the first 4 minutes.

I'm working on the education part, btw😉

 

[Ligament]

Inner-city Ob/Gyn offices are NOT the only place you will encounter patients with HIV, Hep B, Hep C or any other infectious diseases. I certainly hope you have noticed that anyone, despite their race, age or class can be infected with almost anything imaginable. I hope your statement was a simple slip-up.

I disagree w/ you. Having working in both inner-city and wealthy suburban ob/gyn offices in Chicago, I saw FAR FAR less HIV, Hep B, Hep C at the suburban offices. Still there, but much less.

Ckents statement was probably not a slip up.

 

[BellKicker]

I think there's a "quote" missing there, Ligament.

 

[doctormontero]

I'm not sure you really are disagreeing with me, Ligament. You mention that you "saw less" infectious diseases in the suburban population you worked with but you concur that these diseases were present nonetheless. I find it ignorant that you or anyone in the medical field would believe that ANY population is entirely immune from HIV, Hep B or C. You are doing your patients a great disservice if you are assuming their affluence shields them from pathogens.

 

[DrDre']

A bit of a tangent but...

I am always amazed at how parents will let a child wander around their ER room and touch things, sit on the floor, etc.

I know that kids are difficult to watch and harder to control. I also know most laypersons may not realize what a germ factory ANY medical area is, BUT I would not let my kid touch anything in such situations.

When I was a paramedic we would go to health fairs and the kids could check out the ambulance so they could be educated and not be scared if they were ever in need- I was amazed how parents would let their kids touch the floors and all.

An ambulance is never clean and neither is a hospital room.

Parents must take responsibility for their children. It may "take a village" but we can't childproof the whole country no matter what trial lawyers think!

Sorry, little pet peeve, obviously.
To the OP, not to crucify you, just a launching pad, as it were...

 

[docB]

I can't count the number of times I've seen parents (poor term for this ilk, perhaps child observers?) let their kids rummage through everything in the ER.
"What's this Mommy?", "Why that's an anoscope son."

I also can't keep track of how many times a parent has just taken off during their child's workup to do some errends, get their fix or whatever. I'm always amazed how angry they are when they get back. "What do you mean he's not ready to go? I've been gone for hours!" I get to tell them "Well once you as his guardian (such as you are) left I had no right to do any non-lifesaving interventions. You're welcome to hang out while we get things going." I usually get a stream of profanity back for that one. Lately I've just been saying,
"Oh, you're back. We had to assume you abandonded him. This is nice lady is from CPS. Have fun."

 

[Mirror Form]

Originally posted by ckent
Also, next time, lay off of the purrell. studies haven't shown anything to be more efficacious then soap and water.

Uh oh dude, don't even try to bust on purell. Studies have shown that it decreases infections in hosptials significantly. Although, that may not be b/c it's anymore effective then soap, but b/c it's easier and faster to use.

 

[Sessamoid]

Originally posted by Sledge2005
Uh oh dude, don't even try to bust on purell. Studies have shown that it decreases infections in hosptials significantly. Although, that may not be b/c it's anymore effective then soap, but b/c it's easier and faster to use.

I don't think the poster was "busting" on purrell (which I assume is another one of those alcohol based hand cleaners), just said that it wasn't necessary. I agree with that opinion. As far as wound cleansing, water and soap (and lots of them) are the best solution. In fact, large volume irrigation by the patient under a regular sink tap (even without soap) is just as effective as irrigation by the physician with a syringe and 18 gauge catheter, the most commonly used wound cleaning method in the ER.

 

[sweetfynesse]

Originally posted by Sledge2005
Uh oh dude, don't even try to bust on purell. Studies have shown that it decreases infections in hosptials significantly. Although, that may not be b/c it's anymore effective then soap, but b/c it's easier and faster to use.

were those studies supported by the company that make Purell? did you scrutinize those sudies via strict evidenced-based medicine protocol, or did you simply believe the results as they were presented to you?....it makes all the difference...

 

[aphistis]

Originally posted by docB
I can't count the number of times I've seen parents (poor term for this ilk, perhaps child observers?) let their kids rummage through everything in the ER.
"What's this Mommy?", "Why that's an anoscope son."

I also can't keep track of how many times a parent has just taken off during their child's workup to do some errends, get their fix or whatever. I'm always amazed how angry they are when they get back. "What do you mean he's not ready to go? I've been gone for hours!" I get to tell them "Well once you as his guardian (such as you are) left I had no right to do any non-lifesaving interventions. You're welcome to hang out while we get things going." I usually get a stream of profanity back for that one. Lately I've just been saying,
"Oh, you're back. We had to assume you abandonded him. This is nice lady is from CPS. Have fun."

My plans exactly.