Getting Stuck w/ sharps?

[letsgfuad]

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This may be a stupid question, but i shadowed a dentist today and it seems like they get pretty close to sticking themselves with a sharp point often? Is this the case or does it just appear this way. Are there ways to guarentee (besides stupidity) to not prick yourself? If not does this occure often?

I understand that its up to every individual as people who are more cautious have less of a chance, but in general have you guys gotten close or what do you have to say about this?

Thanks

 

[ca_dreamin']

It does happen...especially in dental school. You just have to remember that you always need to be aware of where the instruments are and have a good rest either intraoral or outside the mouth to help decrease the chance that you will stick yourself. Also, they teach you not to hold the cap of a needle while recapping -- some people get careless or just get into the groove of what they are doing and forget this sometimes...

To sum it up, yes it can happen, but if you are careful, you will greatly reduce the chance that it will happen to you. I have yet to have a needlestick, but consider the odds.....you will be in practice most likely for at least 2,3, or more decades.

 

[aphistis]

In my (limited) experience, avoiding needlesticks is much more about developing safe habits than about being consciously careful--i.e., the guy who recaps needles with his fingers, however carefully, is still more likely to stick himself than the guy who scoops needle caps off the tray one-handed.

I've never heard of a dental needlestick that couldn't ultimately be traced back to carelessness. That's not to say they don't exist, but they're certainly not the norm.

 

[ca_dreamin']

I've never heard of a dental needlestick that couldn't ultimately be traced back to carelessness. That's not to say they don't exist, but they're certainly not the norm.

I agree it's not the norm....BUT in dental school you need to be especially alert to your surroundings. We have had some incidents with patients who have been extremely nervous about injections, etc...and have tried to grab the hands of students (and instructors) when they were preparing to admin local anesthesia. You need to be ready to keep yourself and your patient safe.

OP:
Also, (I'm assuming that you are applying to dental school if you are shadowing a dentist) get ready for some fun in pedo. You really need to be prepared for anything. Most kids are great...but some like to move a little more than others 🙂

 

[aphistis]

I agree it's not the norm....BUT in dental school you need to be especially alert to your surroundings. We have had some incidents with patients who have been extremely nervous about injections, etc...and have tried to grab the hands of students (and instructors) when they were preparing to admin local anesthesia. You need to be ready to keep yourself and your patient safe.

Exactly. Those "nervous patient anesthesia twitches" are exactly the scenario I was thinking about when I wrote my preceding post. Keeping yourself & the patient safe in this instance means that, to borrow from one of the OMS guys, "you shouldn't ever put your hands in the patient's mouth; that's why God invented retractors." *Particularly* with nervous patients, that's the kind of emotional state you can (and should) notice ahead of time and take proper precautions against.

Again, I'm not out to demonize or vilify anyone, and I'm certainly not saying people who get stuck are crummy clinicians. All I'm saying is what I already mentioned above, that all but the barest minority of needlestick injuries result from inadequate precaution by the dentist.

 

[scalpel2008]

that's why God invented retractors."

I'm surprised that was on God's list of things to invent...hmm, let me make some planets, dinosaurs, lakes, mountains, other life forms, and OMS retractors. I guess thats what dubya meant by intelligent design eh? although some of our retractors are so dinged up, you would think he would have made them a little more durable!
oh and, i enjoy recapping my needles with my non dominant hand and my eyes closed. keeps things a little exciting. 😎

 

[aphistis]

I'm surprised that was on God's list of things to invent...hmm, let me make some planets, dinosaurs, lakes, mountains, other life forms, and OMS retractors. I guess thats what dubya meant by intelligent design eh? although some of our retractors are so dinged up, you would think he would have made them a little more durable!
oh and, i enjoy recapping my needles with my non dominant hand and my eyes closed. keeps things a little exciting. 😎

Nice try, but I'm not taking the bait. 😉 Let's keep it on topic, please.

 

[letsgfuad]

Thanks for the response. I would be very cautious about that whole deal, as i work with needles now (with morpholinos RNA knockout stuff) and im not too cautious on \those because i work on fish and make new ones everytime. I have yet to stuck myself, so im sure when im/or if im in dentistry i will be much more cautious. Im sure a steady hand helps out a lot too.

 

[galangvu]

Most kids are great...but some like to move a little more than others 🙂

I think you put that in reverse "Most kids like to move around a lot but some will stay still for you to work on them"

 

[DMD2005]

Hi,

I graduated last year from dental school and I just want to warn you guys and tell you to be VERY careful. It did happen to me. But it was in my first or second week of clinic which is a time when every former dental student will tell you that they were the MOST nervous because you are dealing with your own patients for the first time. There are several reasons I think it happened to me:

#1 - it was one of my FIRST patients
#2 - this patient was known HIV+ (makes a dental student shaky at first)
#3 - you often are short of time in your first few clinical sessions so you may rush - DON'T RUSH!!! Your safety is more important

It may make you a little MORE uneasy when you know you are dealing with your first known HIV+ patient...relax, you will have to treat them for the rest of your career. Being nervous with them will surely pass.

When it happened to me, I thought the world was going to end. There I was having just gotten stuck with a bloodied perio instrument from an HIV+ source... However, I immediately ran to Employee Health and was given the retroviral meds - WARNING: don't let a stick happen because these meds are a nightmare!!! (Think month-long stomach virus) Plus, you have to keep getting tested for a year after. Not mention how it put a damper on my whole 3rd year.

To make a long story short, I was fortunate and did not get HIV...very few people do get it from a stick as long as you RUN to employee health (you heard me, RUN don't walk to get your meds).

It's not a stupid question - just be careful - most sticks only happen to inexperienced dental students.

GOOD LUCK, be safe and DON"T GET STUCK!!!!!!!

This may be a stupid question, but i shadowed a dentist today and it seems like they get pretty close to sticking themselves with a sharp point often? Is this the case or does it just appear this way. Are there ways to guarentee (besides stupidity) to not prick yourself? If not does this occure often?

I understand that its up to every individual as people who are more cautious have less of a chance, but in general have you guys gotten close or what do you have to say about this?

Thanks

 

[EyeAmCommi]

DMD2005...Jesus. I can't imagine a worse feeling than getting stuck (emotionally I mean); thanks for sharing your story.

 

[rocknightmare]

Hi,

I graduated last year from dental school and I just want to warn you guys and tell you to be VERY careful. It did happen to me. But it was in my first or second week of clinic which is a time when every former dental student will tell you that they were the MOST nervous because you are dealing with your own patients for the first time. There are several reasons I think it happened to me:

#1 - it was one of my FIRST patients
#2 - this patient was known HIV+ (makes a dental student shaky at first)
#3 - you often are short of time in your first few clinical sessions so you may rush - DON'T RUSH!!! Your safety is more important

It may make you a little MORE uneasy when you know you are dealing with your first known HIV+ patient...relax, you will have to treat them for the rest of your career. Being nervous with them will surely pass.

When it happened to me, I thought the world was going to end. There I was having just gotten stuck with a bloodied perio instrument from an HIV+ source... However, I immediately ran to Employee Health and was given the retroviral meds - WARNING: don't let a stick happen because these meds are a nightmare!!! (Think month-long stomach virus) Plus, you have to keep getting tested for a year after. Not mention how it put a damper on my whole 3rd year.

To make a long story short, I was fortunate and did not get HIV...very few people do get it from a stick as long as you RUN to employee health (you heard me, RUN don't walk to get your meds).

It's not a stupid question - just be careful - most sticks only happen to inexperienced dental students.

GOOD LUCK, be safe and DON"T GET STUCK!!!!!!!

thanks for the info bro. that would def put a hamper on your 3rd year..

 

[tinman831]

that would def put a hamper on your 3rd year..

It would put a hamper on the rest of your life too. 🙁

Glad you're okay dmd2005

 

[J2AZ]

It would put a hamper on the rest of your life too. 🙁

Glad you're okay dmd2005

It always sucks when you get dirty clothes on things. Really puts a damper on the rest of the day. In life, such a situations always hamper success.

 

[tinman831]

It always sucks when you get dirty clothes on things. Really puts a damper on the rest of the day. In life, such a situations always hamper success.

😛

 

[letsgfuad]

so would being paranoid about sticking myself be a reason to not become a dentist. I love the career, from the shadowing i have done, but i am terrified about goign through that whole ordeal previously mentioned.

I shadowed another dentist today and the endodontists had to use a suture. He held the needle in his hand and cupped it. It just seems crazy to do that, but maybe thats the way you do it to protect yourself.

So anyways, would being freaked out about this be a reason to go to podiatry instead? or maybe a mailman =]

 

[DMD2005]

No - it's not a reason to go into Podiatry!!! Even after my life-altering experience, I would still go into dentistry. Don't stress about it.

Seriously, the only time I think it is really likely to happen is when you are a YOUNG, EAGER, INEXPERIENCED dental student...so during this time, just be extra careful...

Good luck soon-to-be dental students!!! 🙂

so would being paranoid about sticking myself be a reason to not become a dentist. I love the career, from the shadowing i have done, but i am terrified about goign through that whole ordeal previously mentioned.

I shadowed another dentist today and the endodontists had to use a suture. He held the needle in his hand and cupped it. It just seems crazy to do that, but maybe thats the way you do it to protect yourself.

So anyways, would being freaked out about this be a reason to go to podiatry instead? or maybe a mailman =]

 

[aphistis]

so would being paranoid about sticking myself be a reason to not become a dentist. I love the career, from the shadowing i have done, but i am terrified about goign through that whole ordeal previously mentioned.

I shadowed another dentist today and the endodontists had to use a suture. He held the needle in his hand and cupped it. It just seems crazy to do that, but maybe thats the way you do it to protect yourself.

So anyways, would being freaked out about this be a reason to go to podiatry instead? or maybe a mailman =]

You're going to be doing surgery as a podiatrist, so I don't think that'd be a good idea either. 😉

 

[letsgfuad]

No - it's not a reason to go into Podiatry!!! Even after my life-altering experience, I would still go into dentistry. Don't stress about it.

Seriously, the only time I think it is really likely to happen is when you are a YOUNG, EAGER, INEXPERIENCED dental student...so during this time, just be extra careful...

Good luck soon-to-be dental students!!! 🙂

Hey thanks you soo much for your input. Ever dentists I talk to say they would become a dentist again if they could. Even after your situation for you to say that, means a field in dentistry is perfect (SSHHHHH dont let the secret out) everyday more and more people are on these dental forums 😡

Anyways, thanks again and if i get accepted those are definately some words of advice "be careful" =]

 

[AhhPuller]

I just don't get why everyone doesn't use retractors or the newer needles with the automatic cappers. Do you use the retractors at all at school or your fingers to hold a patient's cheek?

 

[DMD2005]

NEVER EVER use your fingers to pull back their cheek - if you don't have retractors handy, you usually have a mouth mirror handy.

I just don't get why everyone doesn't use retractors or the newer needles with the automatic cappers. Do you use the retractors at all at school or your fingers to hold a patient's cheek?

 

[Trookie]

Thank goodness you are alright. I'm only a rising D2, so I'm not completely familiar with how things work in clinic. Were you assigned the patient? Why would the school assign a known HIV+ patient to a newbie, instead of a D4? I'd be incredibly nervous after having only one week's experience of working on patients as well.

 

[dentalman]

You are supposed to practice "Universal precautions". Are you planning to stick yourself with a needle or sharp when working on a completely healthy patient? No. If you start doing things differently, and not your usual habit, you may be more likely to have a needle stick. A needle stick is very unlikely to transfer infectious disease, but the emotional feeling is not good, nonetheless. I thought I would be freaked out about this before school, too, but if you treat them like every other patient (which you are obligated ethically and legally to do), it makes it easier.

First thing when you start working with needles, talk to five upperclass men about how they cap a needle, and dispose of a needle. (Also an important step). One will probably be practicing unsafe habits, but most will have a good habit. There is not one right way, but you just want to be safe and do it the same every time.

Why isn't dentistry using the automatic retracting needles? Because in dentistry it is common to do multiple injections with the same needle. It may happen eventually with legislation, but there are actually more needle sticks with those when people try to unretract them, because they are not meant to unretract. (This was what I was told by a dental anesthesiologist... haven't used them myself.)

Another piece of advice: Don't wear loupes while giving injection. Or at least NEVER look through the loupes while giving the injection. This is a common cause of needle pricks in school. I wanted to have good peripheral vision so I wore regular safety glasses for the injection, then switched to loupes afterwards. But I am mr. safety.

 

[Ankylosed]

You are supposed to practice "Universal precautions". Are you planning to stick yourself with a needle or sharp when working on a completely healthy patient? No. If you start doing things differently, and not your usual habit, you may be more likely to have a needle stick. A needle stick is very unlikely to transfer infectious disease, but the emotional feeling is not good, nonetheless. I thought I would be freaked out about this before school, too, but if you treat them like every other patient (which you are obligated ethically and legally to do), it makes it easier.

Good info, but I wanted to correct you on one statement. The injection needles are more likely to transmit blood borne pathogens than solid suturing needles. The injection needles are cannulated and retain more bioburden than other types of needles. Furthermore, when you get stuck the blood in the needle can actually be pulled into your wound by capillary action. Cannulated sharps are always high risk for transmission..

 

[pokwadent]

Good info, but I wanted to correct you on one statement. The injection needles are more likely to transmit blood borne pathogens than solid suturing needles. The injection needles are cannulated and retain more bioburden than other types of needles. Furthermore, when you get stuck the blood in the needle can actually be pulled into your wound by capillary action. Cannulated sharps are always high risk for transmission..

How long HIV virus can live in the open air after touching with the blood?

 

[armorshell]

Yeah, needle sticks happen.

I just got needle stuck last week cleaning an operatory. I had just disposed of all the sharps (so I thought) and started to throw all of the instruments onto a tray. Low and behold, the dentist snapped the Tofflemeyer and the shard dug itseld a quarter centimeter into my finger 🙁

It's always the scariest thing ever when you finish cleaning the wound and double check the patients medical history...she was clean though 🙂

 

[scalpel2008]

Yeah, needle sticks happen.

I just got needle stuck last week cleaning an operatory. I had just disposed of all the sharps (so I thought) and started to throw all of the instruments onto a tray. Low and behold, the dentist snapped the Tofflemeyer and the shard dug itseld a quarter centimeter into my finger 🙁

It's always the scariest thing ever when you finish cleaning the wound and double check the patients medical history...she was clean though 🙂

checking the medical history doesn't mean anything. having their blood drawn and tested is what matters.

 

[nabeya]

Well, I'm a 4th year medical student and after searching for " needlesticks", I found this thread. Yesterday during a c-section that I was assisting, I got stuck with a suture needle by the scrub tech as we were closing up the fascia. The patient is a known carrier of Hep C. I know there is only a 2.8% chance of contracting the disease through a needlestick, but I'm telling you that the paranoia is not a good feeling, especially having to wait for 12 weeks to get rechecked after yesterdays baseline labs.

Anybody else get stuck by a Hep C suture needle and have an experience to share? This sucks...

 

[scalpel2008]

i see people quoting percentages and i understand there are studies to back these figures up. But you have to take into account the quantity of virus present in the carriers blood, ie, viral load for HIV and the quantitative PCR in HCV. It would only seem logical that a getting stuck with contamination from a carrier with a higher quantity of virus would result an increased risk of transmission and vice versa.

 

[letsgfuad]

How long HIV virus can live in the open air after touching with the blood?

It does not survive outside the body for long. if there is a pool of blood im sure it can survive a little longer than if no blood was present, but basically the transmission has to be direct. IE needles, blood to blood, etc

 

[cba]

Hi,

I graduated last year from dental school and I just want to warn you guys and tell you to be VERY careful. It did happen to me. But it was in my first or second week of clinic which is a time when every former dental student will tell you that they were the MOST nervous because you are dealing with your own patients for the first time. There are several reasons I think it happened to me:

#1 - it was one of my FIRST patients
#2 - this patient was known HIV+ (makes a dental student shaky at first)
#3 - you often are short of time in your first few clinical sessions so you may rush - DON'T RUSH!!! Your safety is more important

It may make you a little MORE uneasy when you know you are dealing with your first known HIV+ patient...relax, you will have to treat them for the rest of your career. Being nervous with them will surely pass.

When it happened to me, I thought the world was going to end. There I was having just gotten stuck with a bloodied perio instrument from an HIV+ source... However, I immediately ran to Employee Health and was given the retroviral meds - WARNING: don't let a stick happen because these meds are a nightmare!!! (Think month-long stomach virus) Plus, you have to keep getting tested for a year after. Not mention how it put a damper on my whole 3rd year.

To make a long story short, I was fortunate and did not get HIV...very few people do get it from a stick as long as you RUN to employee health (you heard me, RUN don't walk to get your meds).

It's not a stupid question - just be careful - most sticks only happen to inexperienced dental students.

GOOD LUCK, be safe and DON"T GET STUCK!!!!!!!

Thanks for the advice.