Give it to me straight- no chasers

[prettymd05]

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Ok, so i got into medical school and now I am reading this allo thread and u people are scaring the ish out of me. Now I have some questions so if some of you can answer, great.

1. I just read in another post how this person saw two other residents get "sprayed" by the fluid of an HIV+ woman during childbirth. How common is this? I mean really?

2. In keeping with the same line of questioning, are medical students innately putting their lives at risk? and if you will, what are the biggest risks in terms of clinical care? How can one prevent and or take the necessary precautions?

I would just like to note that my passion for medicine is strong and I am ready (as much as I can be) for the challenges that lie ahead. However, I am coming to the realization that I may have to worry about my personal health in medical school as well as my mental health (that one was a given). Let me know how you all of dealt/reconciled/confronted these issues.


-pretty

 

[skypilot]

Don't worry too much about infections. You will automatically be at higher risk because you are a health care worker, but everyone wears gloves and eye protection and gowns when necessary and your risk of catching the biggies Hep C, and HIV is extremely low and your risk for Tb is low as well. Just stay aware of universal precautions and wash your hands before and after each patient and you will be fine.

I think you do have to work harder to protect your mental health though.

 

[emack]

Yeah... what skypilot said-- especially regarding universal precautions.

Don't forget that in any hospital, there are hundreds of people who are exposing themselves to as much (or more) risk as you'll be facing, but for way less money: nurses, orderlies, techs, volunteers, other patients, and anyone else who works in a hospital & comes in direct or indirect contact with potentially infectious patients.

Realistically, health care workers are still more likely to die in a car accident on the way to work than to become HIV positive as a result of their career.

 

[bigfrank]

If you're on OB/Gyn and there is an HIV (+) patient delivering, I would advise you to fake a syncopal episode and get the hell outta there.

Just my $0.02.

 

[Rafa]

It'll be like that scene in 'Dawn of the Dead', when the dark-haired lady was giving zombie-birth. Creepy. But the way the main character (blonde lady) ended the scene?

Damn.

 

[BaylorGuy]

Don't worry too much about infections. You will automatically be at higher risk because you are a health care worker, but everyone wears gloves and eye protection and gowns when necessary and your risk of catching the biggies Hep C, and HIV is extremely low and your risk for Tb is low as well. Just stay aware of universal precautions and wash your hands before and after each patient and you will be fine.

I think you do have to work harder to protect your mental health though.

On the same note, many hospitals will give free tests if there are any sorts of needle sticks and/or exposure to HIV/AIDS/Hep C and other harmful, yet somewhat, contagious diseases.

 

[anon-y-mouse]

I read somewhere that the chances of HIV+ needle stick leading to HIV+ infection are 1/320... but this risk is further mitigated with immediate regimen of antivirals (covered by the hospital / med school). Correct me if I'm wrong? What about that whole "spray of fluid" thing? What about conducing pelvics on Hep / HIV women? Do people wear eye protection for that... how does it work?

 

[liveandlearn]

Look! If you do not have an insult (cut/sore) then you WILL NOT get a BLOOD BORNE disease such as HIV/HCV from contact with it. The virals must have contact with either mucous membranes or a cute/injury/sore. So, you can be sprayed with the juices of a pregnant woman with HIV and not get it as long as it does get in your mouth or through an insult in your skin. Moral of the story, wear gloves and eye/mouth protection and you WONT get HIV/HCV. This misconception leads to HORIFIC treatment of HIV positive patients and is the direct result of STUPID DOCTORS AND NURSES. DONT BE AN IDIOT, TREAT YOUR PATIENTS WELL, THEY ARENT GOING TO KILL YOU!

 

[bigfrank]

OK, but I'd still fake a syncopal episode and get out. 😀

 

[Law2Doc]

OK, but I'd still fake a syncopal episode and get out. 😀

Just stand behind someone less senior -- that's what they're there for.

 

[GAdoc]

Just stand behind someone less senior -- that's what they're there for.

In the same line as this, how common are needle sticks? I saw on another thread somewhere in the residency postings where people were talking about their second sticks....in ONE WEEK! Granted, MSIII, IV, and residents are all overworked and exhausted, but is that just incompetence? Doctors I talk to act like getting stuck even once is horrific. So why were all these med students sharing war stories about needle sticks? I agree that HIV+, HCV+ patients deserve the same care as others, but who would go into medicine if it was common to be stuck twice in a week? That would be like a death sentence. What do yall think?

 

[Emergency!]

Granted, MSIII, IV, and residents are all overworked and exhausted, but is that just incompetence? Doctors I talk to act like getting stuck even once is horrific.

IMO - Its mostly incompetence and/or inexperience and/or being lax with needle procedures - not necessarily on the part of the person being stuck. The two times I have been stuck by a needle (in my previous career as an EMT), both were my fault. I set needles down on the bench seat of the ambulance instead of putting them in the sharps container (as protocol dictates you should) and later sat on them or ran my hand into them. New medical personal tend to be the ones getting stuck because 1- we don't have it ingrained in our brains the proper way to take care of them and 2 - we get in the way of others with needles and accidentally get stuck.

 

[BaylorGuy]

IMO - Its mostly incompetence and/or inexperience and/or being lax with needle procedures - not necessarily on the part of the person being stuck. The two times I have been stuck by a needle (in my previous career as an EMT), both were my fault. I set needles down on the bench seat of the ambulance instead of putting them in the sharps container (as protocol dictates you should) and later sat on them or ran my hand into them. New medical personal tend to be the ones getting stuck because 1- we don't have it ingrained in our brains the proper way to take care of them and 2 - we get in the way of others with needles and accidentally get stuck.

Ding ding ding....experience is the best teacher....if you dont learn the first time, the next times you will 👍 👍

 

[Psycho Doctor]

it's mostly inexperience causing accidental needle sticks. Be glad there are now precautions and immediate blood tests for these conditions. There are also treatments which are more effective than years ago. Yes, treatment for HCV totally sucks but if you get treatment immediately when the VL is lower, there's a much greater chance of attaining a SVR.

 

[tupac_don]

Ok, so i got into medical school and now I am reading this allo thread and u people are scaring the ish out of me. Now I have some questions so if some of you can answer, great.

1. I just read in another post how this person saw two other residents get "sprayed" by the fluid of an HIV+ woman during childbirth. How common is this? I mean really?

2. In keeping with the same line of questioning, are medical students innately putting their lives at risk? and if you will, what are the biggest risks in terms of clinical care? How can one prevent and or take the necessary precautions?

I would just like to note that my passion for medicine is strong and I am ready (as much as I can be) for the challenges that lie ahead. However, I am coming to the realization that I may have to worry about my personal health in medical school as well as my mental health (that one was a given). Let me know how you all of dealt/reconciled/confronted these issues.


-pretty

1) Yea it's possible, very possible particularly at inner city hospitals. You will see a fair amount of HIV pts delivering, you just gotta have appropriate precautions and you'll be A ok.

2) Putting your lives at risk, I mean you are worrying about putting your life at risk, as a student, if you think like that you will be putting your life at risk your whole life as a doctor. I mean you are in somewhat higher risk than your average individual, just because of the exposure to this stuff, where most people are not exposed to this stuff on daily basis. But with appropriate precautions you should be ok. You might be in trouble if you have some immune deficiency problems, but that's a whole different story.

As far as mental health. I think to stay sane in med school and not get overwhelmed, main thing is support. If you have good support, both out and at med school, you will be probably ok. This is something that person specific, but having the support and having good friends where you can vent frustrations and explain your point of view will help a lot.

But I'll give you an analogy here, putting your life at risk as a doctor is no different than being a truck driver (who is always putting his life at risk on the road) or police officer or fireman. I mean with proper precautions, you can have very succesful and long lived career.

Also where you practice will really determine your risk exposure, if you are a surgeon, you might be more at risk than if you are a internal medicine doctor. But risk is all relative, with good precautions, you don't have too much too worry about.

 

[glorytaker]

On the same note, many hospitals will give free tests if there are any sorts of needle sticks and/or exposure to HIV/AIDS/Hep C and other harmful, yet somewhat, contagious diseases.

We were told by our school that if anything like that happened, we're on our own and that the hospitals will NOT test us for free or anything as we aren't employees.

 

[prettymd05]

Thanks to everyone who replied to my questions. I appreciate it greatly. Now, I will have some great questions to ask during my second look weekends coming up at the schools that I am interested in, particularly about how the school and hospital deals with these types of scenarios.

-pretty

 

[mojojojo]

What about conducing pelvics on Hep / HIV women? Do people wear eye protection for that... how does it work?

Seriously? Ok... well, I worked in an ob/gyn clinic for a year before med school and never once saw anyone put on goggles for a pelvic. Although now I'm wishing they had, because it would have been funny. But to answer your question, there isn't any "spraying" during a pelvic. The only in-clinic procedures that got really messy were bartholins cyst drainages, and yes, I would wear a mask/goggles for those, because often the first incision yields a bit of an explosion.... hopefully no one is reading this while eating lunch.

Here is what I most wanted to address about your question though -- you're asking the WRONG question. If you are wondering if you use different procedures for patients with different diseases, you're really not understanding the concept of personal protection. It's so important to treat EVERYONE like they have the possibility of transmission infection. I also worked in a hospital and noticed how some of the older nurses would whisper, "Patient's got Hepatitis" and put on a pair of gloves. For me, I always already had them on and nothing ever changed with an infected patient. The truth is, you can NEVER know what a patient has, so don't treat anyone differently.

But for the original poster, even with a needle stick, the chances of infection are low. Health care workers are at higher risk, but that's why we get all the fun vaccines that we do. So no worries -- except for your mental health. Yeah, that's in trouble.

😉

 

[Law2Doc]

it's mostly inexperience causing accidental needle sticks.

Sort of. I've heard of places where the less senior folk are called "killer bees" because of the high incidence of them accidently sticking others. It happens. More prevalent is the likelihood of surgeons nicking themselves through their gloves. But the risks of actually contracting anything are exceedingly low, and whatever precautions can be taken generally are.

 

[nala]

We were told by our school that if anything like that happened, we're on our own and that the hospitals will NOT test us for free or anything as we aren't employees.

that's awful. At my school, we get tested and get prophylactic Rx if indicated.

 

[tupac_don]

Seriously? Ok... well, I worked in an ob/gyn clinic for a year before med school and never once saw anyone put on goggles for a pelvic. Although now I'm wishing they had, because it would have been funny. But to answer your question, there isn't any "spraying" during a pelvic. The only in-clinic procedures that got really messy were bartholins cyst drainages, and yes, I would wear a mask/goggles for those, because often the first incision yields a bit of an explosion.... hopefully no one is reading this while eating lunch.

Here is what I most wanted to address about your question though -- you're asking the WRONG question. If you are wondering if you use different procedures for patients with different diseases, you're really not understanding the concept of personal protection. It's so important to treat EVERYONE like they have the possibility of transmission infection. I also worked in a hospital and noticed how some of the older nurses would whisper, "Patient's got Hepatitis" and put on a pair of gloves. For me, I always already had them on and nothing ever changed with an infected patient. The truth is, you can NEVER know what a patient has, so don't treat anyone differently.

But for the original poster, even with a needle stick, the chances of infection are low. Health care workers are at higher risk, but that's why we get all the fun vaccines that we do. So no worries -- except for your mental health. Yeah, that's in trouble.

😉

I somewhat disagree with you, for sure I'll be careful with any pt, but wouldn't you be extra careful when you know that someone has a deadly disease. That's just my rationale.

 

[OSUdoc08]

Ok, so i got into medical school and now I am reading this allo thread and u people are scaring the ish out of me. Now I have some questions so if some of you can answer, great.

1. I just read in another post how this person saw two other residents get "sprayed" by the fluid of an HIV+ woman during childbirth. How common is this? I mean really?

2. In keeping with the same line of questioning, are medical students innately putting their lives at risk? and if you will, what are the biggest risks in terms of clinical care? How can one prevent and or take the necessary precautions?

I would just like to note that my passion for medicine is strong and I am ready (as much as I can be) for the challenges that lie ahead. However, I am coming to the realization that I may have to worry about my personal health in medical school as well as my mental health (that one was a given). Let me know how you all of dealt/reconciled/confronted these issues.


-pretty

1. Wear a face shield during your OB rotation. Blood & Body precautions are readily available for you.

2. There are many, many other jobs that are more risky than medicine. (i.e. Police, Firefighter, Paramedic, Military, Construction, Farming, Transportation, etc.)

3. You don't need to worry about your personal or mental health. Don't take anything too seriously, and you'll be fine.

 

[UDbiochem]

The statistic given to us in class just this past week was: Nationwide, only 0.3% health care workers contracted HIV from a needlestick from a known HIV+ patient (after taking the prophylaxis.) So low... don't stress.

 

[Random]

Actually, that stat's for a hollow needle; something like a lancet would have a lower chance of seroconversion. And I don't know about inexperience or incompetence causing needle sticks. It seems to me that a number of experienced and otherwise competent people get them because they aren't as careful as they perhaps should be, even just on the one occasion.

 

[8744]

I stuck myself with a clean needle on my first attempt to draw blood as a third year. That's all it took and now I am anal about sharps. I won't even adjust needle on a driver without using pick-ups.

 

[THP]

I remember the first day of Gross Anatomy, the teacher said our main goal for the day was not not cut eachother. Within minutes of him giving that instruction, my lab partner sliced me with the scalpel.

 

[Benzo4every1]

Ok, so i got into medical school and now I am reading this allo thread and u people are scaring the ish out of me. Now I have some questions so if some of you can answer, great.

1. I just read in another post how this person saw two other residents get "sprayed" by the fluid of an HIV+ woman during childbirth. How common is this? I mean really?

2. In keeping with the same line of questioning, are medical students innately putting their lives at risk? and if you will, what are the biggest risks in terms of clinical care? How can one prevent and or take the necessary precautions?

I would just like to note that my passion for medicine is strong and I am ready (as much as I can be) for the challenges that lie ahead. However, I am coming to the realization that I may have to worry about my personal health in medical school as well as my mental health (that one was a given). Let me know how you all of dealt/reconciled/confronted these issues.


-pretty

You have a pretty low chance of getting HIV unless your skin is not intact. Provided that the fluid being sprayed has a high viral content. Nonetheless you would worry more about HBV rather than HIV since youre more likely to get that if youre poked with a big bore needle. Medicine is fun and exciting!!! So if you happen to be around a patient, near procedures, just treat everyone like they have HIV and you will be fine 😉

 

[CANES2006]

If you're on OB/Gyn and there is an HIV (+) patient delivering, I would advise you to fake a syncopal episode and get the hell outta there.

Just my $0.02.

Since I will be practicing in Miami, where the rate of HIV (+) women is well above the national rate, I would have to fake a syncopal episode after every other birth. Somehow I don't think this will work. I'll probably be unemployed. 😉 Anyway, to the original poster, don't freak out. Just wear double gloves, protective eye wear and gowns and that's all she wrote.

P.S. I believe it's more common for orthopods to get splashed than OB-GYNers. At least that's why they are always at the health office at my hospital.

 

[azzarah]

If you're on OB/Gyn and there is an HIV (+) patient delivering, I would advise you to fake a syncopal episode and get the hell outta there.

Just my $0.02.

👍

I got stuck on my surgery rotation and let me tell you, it was no fun at all.

 

[RonaldColeman]

The first part of my rotation on OB was high risk. I had never even scrubbed in on any procedure, so I really didn't even know how to gown and glove. Our first delivery was an HIV+ lady. I did the unthinkable and told my resident that I didn't feel ready to deliver a baby under these circumstances. I risked a bad evaluation, but luckily she was really cool about it.