needle

[jeesapeesa]

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to all attendings/residents: have you guys ever been stuck with a needle/ splashed with blood, traumatized or have been in risky situations like these when practicing anesthesiology? what are the chances?

 

[coprolalia]

Well, resident here. Never been stuck, but have washed blood off of my bare hands too many times to count. I have my Hep B vaccination up to date. Am always extra careful when I know a patient has a virus and in the trauma bay. But, shyite happens from time to time. So long as you don't have any open cuts on your hands (or the like) probably not a big deal to get splashed, not that I actually try to have this happen.

-copro

 

[Dejavu]

Attending here...
I have been stuck twice by dirty needles. Both times after the block while trying to put the sharps into a teeny sharps-bucket opening. Now I take the whole kit to a big bucket and dump all of it at once instead of touching sharp things more than I need to. My understanding is that the risk, even in a known HIV patient, is small, but still.

 

[lobelsteve]

Attending here...
I have been stuck twice by dirty needles. Both times after the block while trying to put the sharps into a teeny sharps-bucket opening. Now I take the whole kit to a big bucket and dump all of it at once instead of touching sharp things more than I need to. My understanding is that the risk, even in a known HIV patient, is small, but still.

Smart practices make safer doctors.

Consider every patient too have HIV/Hep B/C.
Universal precautions
The bigger the sharps container, the easier it is to dispose of needles and the less fuss of tapping in catheter stylets, lead blanks, Quincke's, etc.
Bus your own tray. It is the docs responsibility to clean up their own sharps.
Never recap a needle ( I do not follow my own advice here either).
Never recap a used needle. ( I follow my own advice here.)

Use a forceps, clamp, or pickups to place used needles in the sharps bin. (If it were not twice as time consuming I probably would do this.)

How about, use the needle stick pad that comes in the trays, then throw the entire block with no needle points sticking out of it into the bin. I have seen as many sticks with the needle coming through the bottom of the pad as I have without using the pad. I'd recommend keeping an eye on the tips of all needles.

Never rush, the risk of transmission is low, but tell that to the doc who got Hep B/C from cleaning up quickly to get to the next case.

 

[Ferdie]

I've never been stuck, but here's an interesting little story:

last spring after my yearly checkup, after having had a bunch of labs drawn (including an HIV test), the OBGYN came in the room and said "well, I have some bad news, your test came back positive." I FREAKED out - I jumped to the worst possible conclusion and thought 'ohmigod I have HIV and I'm gonna DIE,' and started sobbing. The OB just looked at me kind of strangely. It turns out I am positive for the Factor V Leiden clotting disorder (my sister had a DVT at 16 and tested positive, so I was getting it checked out before renewing my OCP rx), NOT for HIV.
She proceeded to spend the next several minutes telling me not to go into anesthesia because I am afraid of HIV. Um, yeah, I have a healthy fear of HIV, but I was thinking, 'YOU CAN'T FORGET TO TELL SOMEONE WHAT TEST YOU'RE TALKING ABOUT!'

 

[gas87]

I've never been stuck, but here's an interesting little story:

last spring after my yearly checkup, after having had a bunch of labs drawn (including an HIV test), the OBGYN came in the room and said "well, I have some bad news, your test came back positive." I FREAKED out - I jumped to the worst possible conclusion and thought 'ohmigod I have HIV and I'm gonna DIE,' and started sobbing. The OB just looked at me kind of strangely. It turns out I am positive for the Factor V Leiden clotting disorder (my sister had a DVT at 16 and tested positive, so I was getting it checked out before renewing my OCP rx), NOT for HIV.
She proceeded to spend the next several minutes telling me not to go into anesthesia because I am afraid of HIV. Um, yeah, I have a healthy fear of HIV, but I was thinking, 'YOU CAN'T FORGET TO TELL SOMEONE WHAT TEST YOU'RE TALKING ABOUT!'

Ferdie, I don't think your OB was trying to say that you would be a bad anesthesiologist, but she made a good point about the fact that it is uniquely stressful. The attendings and residents that I know who enjoy anesthesiology the most are those that NEVER freak out. You could tell them anything, or throw them into any situation, and they would respond calmly.
I know plenty of anesthesiologists who freak out constantly, and it seems like their working lives are pretty unpleasant. They often are great at what they do, but it seems to take a big toll on them personally.
Imagine this: if you were the only person at your first code, would you be thinking "awesome!" as you automatically reached for the head to put the pt in sniffing position? (in a pt with no possibility of C-spine trauma, of course)
Or, would you be thinking "oh my g-d, I've never done this before on a real patient, I don't know what to do, where the hell is everyone".
In anesthesia, there are CONSTANTLY situations where it appears that the patient will die immediately without your intervention. Often, you have to decide VERY quickly how you are going to intervene based on many options and limited information. The question is, do you enjoy this kind of stress, or would it drive you nuts?

 

[Ferdie]

Ferdie, I don't think your OB was trying to say that you would be a bad anesthesiologist, but she made a good point about the fact that it is uniquely stressful. The attendings and residents that I know who enjoy anesthesiology the most are those that NEVER freak out. You could tell them anything, or throw them into any situation, and they would respond calmly.
I know plenty of anesthesiologists who freak out constantly, and it seems like their working lives are pretty unpleasant. They often are great at what they do, but it seems to take a big toll on them personally.
Imagine this: if you were the only person at your first code, would you be thinking "awesome!" as you automatically reached for the head to put the pt in sniffing position? (in a pt with no possibility of C-spine trauma, of course)
Or, would you be thinking "oh my g-d, I've never done this before on a real patient, I don't know what to do, where the hell is everyone".
In anesthesia, there are CONSTANTLY situations where it appears that the patient will die immediately without your intervention. Often, you have to decide VERY quickly how you are going to intervene based on many options and limited information. The question is, do you enjoy this kind of stress, or would it drive you nuts?

I think being the first one to a code and being told you have HIV are completely different things. I was an open-water lifeguard for 6 years and have been involved in many rescues, 2 of which involved spinal cord injuries, and I thrive in that situation.
My OB's point was not that anesthesia puts you in stressful situations and I can't respond to stress, it was that anesthesia puts you at risk for needle sticks more than other specialties, putting you at higher risk for HIV. I would argue that many a great anesthesiologist, if told their HIV test was positive, would get a bit emotional.

 

[Sevo]

to all attendings/residents: have you guys ever been stuck with a needle/ splashed with blood, traumatized or have been in risky situations like these when practicing anesthesiology? what are the chances?

Expect to be stuck at least once in your career. I've been stuck five times, most of them due to being careless during a quick line placement or, the dreaded no-no, recapping needles.

Of note, when you apply for disability insurance, expect to be tested for HIV and Hep C.