Needle stick during rotation!!

[MCATTT]

This question is for a sdn friend who didn't want to disclose his username.

Anyway, what are the chances of getting HIV/Hep after getting a clean needle stick thru a "questionable dirty" glove?
He was putting IV line with the gloves on. After putting IV, there was some blood on the patient's arm but not sure if it was on the glove (he was wiping off blood with 4x4s using same glove though). After putting IV, he was told to do a butterfly stick and get pricked with the back end rubber thingy where there is a sharp needle underneath (know what i am talking about?) on the thumb by accident. Needle is clean, so didn't get worried and decided not to report. Two days later, starting to freak out after deciphering whether or not the glove was clean. (pt has no hx of HIV, hep, but could be not disclosing?)

Any input will be appreciated!

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[psychforme]

sdn is not for personal medical advice...

 

[QofQuimica]

This question is for a sdn friend who didn't want to disclose his username.

Anyway, what are the chances of getting HIV/Hep after getting a clean needle stick thru a "questionable dirty" glove?
He was putting IV line with the gloves on. After putting IV, there was some blood on the patient's arm but not sure if it was on the glove (he was wiping off blood with 4x4s using same glove though). After putting IV, he was told to do a butterfly stick and get pricked with the back end rubber thingy where there is a sharp needle underneath (know what i am talking about?) on the thumb by accident. Needle is clean, so didn't get worried and decided not to report. Two days later, starting to freak out after deciphering whether or not the glove was clean. (pt has no hx of HIV, hep, but could be not disclosing?)

Any input will be appreciated!

Tell him not to be an idiot and to call the exposure hotline. It's there for a reason.

 

[werd]

dude. needle sticks need to be reported; hospitals have protocols for these things.

 

[Bartelby]

Yeah, he should have reported it. That said his chances of contracting HIV/Hepatitis are pretty much zero from what I am reading. He was wiping blood with 4x4s (thus gloves were probably clean) and he poked himself through them with a clean needle. Even if the needle and gloves were dirty his chances would be low from a single stick. I would not sweat it too hard but he should still bring it to official attention.

Keep in mind that I am basing my likelihoods on hearsay and not on any real survey of the literature.

 

[Dwindlin]

If I remember correctly the chance of HIV seroconversion from a needle stick is ~0.3%

That said, your friend still needs to report the stick.

 

[stebby]

while HIV seroconversion is only 0.3%, hepatitis B is approximately 30%

but with no clinical evidence of either condition, not really any risk

 

[McGillGrad]

1:300 for HIV

1:30 Hep C

Heb B (but should be vaccinated)

 

[MCATTT]

Just an update!
he reported it to employee health, did some inquiry with pt's PMD, turn out it is
low risk pt with Hep C/HIV neg since beginning of the year when pt came for annual check up.
no visible blood, clean needle, low risk pt = virtually zero chance.

Thank you all for your input!!

It's really irritating to be working so hard all your life to become a doctor and one small move could turn everything upside down. Never wrong to play it safe no matter how confidence you feel.
Just a caution, never search pt's bags for whatever reason (trying to get pt's insurance ID, doctor card, medications, etc). There are stories of people getting stuck with insulin needles while going thru pt's belongings.

 

[rjmn]

I read an interesting article about retractable syringes and how misguided government policies are posing an obstacle to their adoption:
http://www.washingtonmonthly.com/features/2010/1007.blake.html

But still, why aren't doctors pushing more strongly for these needles to be used in hospitals? They should bring needlestick exposures way down.

 

[jjesusfreak01]

I'm just an EMT at the moment, but I do not believe I have ever seen a medic do an IV without some sort of safety needle. Mostly retractable, but one had a weird no stick tip that became non pointy after you use it.

 

[Jolie South]

I'm just an EMT at the moment, but I do not believe I have ever seen a medic do an IV without some sort of safety needle. Mostly retractable, but one had a weird no stick tip that became non pointy after you use it.

When I did needle stick safety orientation at the VA, all the needles were retractable or blunt-able after injection/insertion.

 

[MicA]

I would have gone on PEP regardless... You are kind of screwed if you only start doing something more than 72 hours after it happens.

I know people here that have had needle sticks. No matter what they all go on PEP. Seems like every hospital has a number to phone to get treatment immediately.

 

[McGillGrad]

I would have gone on PEP regardless... You are kind of screwed if you only start doing something more than 72 hours after it happens.

I know people here that have had needle sticks. No matter what they all go on PEP. Seems like every hospital has a number to phone to get treatment immediately.

Studies have shown that many people stop PEP due to side effects. The US is not exactly SA, so the HIV fear rate is not as high for needle sticks.

 

[Jolie South]

Also, did your friend report the incident? At one of the facilities I work at, they do a rapid HIV to stratify risk for PEP.