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Risk of HIV transmission in a streetfight

Discussion in 'Emergency Medicine' started by fedor, Dec 8, 2005.

  1. fedor

    fedor gunning like the NRA
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    While the risk of HIV transmission w/ a needle stick is quite low, how about in a streetfight?

    If a patient presents with abrasions on hands, how likely is it that HIV could be transmitted?

    Is there even a protocol for dealing with this?
     
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  3. Febrifuge

    Febrifuge Grizzled Old Newcomer
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    In your example, are you saying the person with the hand lac has the HIV, or do they have a hand lac from punching someone (sorry -- 'abrading their hand against a tooth') who has HIV? And are you asking about transmission from puncher to punchee?

    In either case, and assuming this is the question, the chances of the healthcare provider contracting HIV seems very low. Except of course if you plan on having unprotected rough sex with patients (which they tell me is considered a no-no). :D

    When I work as a tech, my EMT training means I always have gloves on, even if other techs snicker. Which they are welcome to do. I've never touched blood with my bare hands, and therefore don't need to care if it's HIV-infected or not.
     
  4. leviathan

    leviathan Drinking from the hydrant
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    I guess the joke's on them if they get HIV! :p I know when I am treating patients, I always wear gloves as well...even when I'm treating an injury that has no blood (eg. ankle fracture or something like that), I don't want to have my bare hands on their smelly feet.
     
  5. Febrifuge

    Febrifuge Grizzled Old Newcomer
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    Word to that. Once, getting ready to move a patient, another tech asked me "where did you get those gloves from?" I told her, "from my pocket."

    She looked at me as if to say, "you are a giant nerd." But then what she said was, "uh... you have another pair?"

    And that's my story about gloves. The End. +pad+
     
  6. leviathan

    leviathan Drinking from the hydrant
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    I carry a face shield and pair of gloves in a compartment on my keychain. Nerdy? Perhaps, but I've had to replace those gloves three times in the last year as a bystander witnessing various incidents. One was a fight outside a bar (while I was waiting to get in) when the guy got knocked out and had a nasty blow to the head after falling onto the concrete...minor lac but it was bleeding quite profusely. That's MY story du jour. +pad+
     
  7. Febrifuge

    Febrifuge Grizzled Old Newcomer
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    I stopped by the roadside for the first time ever last week. The look of relief on the rural volunteer firefighter's face was awesome. Nothing says "it's all under control" like some dude walking over with a crash bag over his shoulder, in the midst of putting on purple nitrile gloves.
     
  8. GiJoe

    GiJoe Senior Member
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    i wear gloves with every single patient encounter...not b/c they're bleeding but some people are just nasty
     
  9. docB

    docB Chronically painful
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    I'd say that being the sort of person who gets into street fights is an independent risk factor for HIV regardless of the amount of blood transfer involved.
     
  10. FoughtFyr

    FoughtFyr SDN Lifetime Donor
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    Hey, gentle now, some of us may have wilder pasts than others... ***looking sheepishly at knuckle scars***

    - H
     
  11. leviathan

    leviathan Drinking from the hydrant
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    What's in your crash bag? If it is what I think it is, we call 'em "jump kits" up here in Canuckada.
     
  12. FoughtFyr

    FoughtFyr SDN Lifetime Donor
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    Here is what I have in both my wife's and my cars. It is a commercial kit from Dixie EMS and fits into a little case (it is actually a men's dob kit case), but it has everything you need for the first few minutes of any trauma.

    "Utilized by various divisions of the US Treasury Department, this custom made kit has everything needed to accommodate emergency needs in a compact easy to carry or wear nylon bag.

    Contents 1-each of 80mm, 90mm, 100mm Dixie Berman Airways
    1-Dallas Suction Unit
    1-Dixie Combo CPR Mask w/ NRV
    1-Thumb Dressing 5 1/2" Forceps
    1-Dixie Diagnostic Penlight
    1-Combisnips Scissors
    1-Kelly 5 1/2" Straight Forceps
    2-Oval Eye Pads
    2-Pairs of Gloves
    1-5" x 9" Abdominal Dressing
    2-Blood Stopper Bandage
    2-Triangular Bandages
    1-Cling Stretch Gauze 3"
    1-Cling Stretch Gauze 4"
    10-1" x 3" Bandaid Strips
    1-4" x 4" Sterile Sponge
    1-4" x 4" Burn Stop Pad
    1-Dermicel Tape
    2-Elastogel
    5-Antimicrobial Wipes"

    I like having the Dallas suction to go along with the mask. It would beat mouth to airway clearance :barf:

    - H
     
  13. Jambi

    Jambi Caldari
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    Here is a case where HIV and Hep C was transmitted after a blow with a fist.

    PubMed link
    Link to full article


    Brief
    Full article
     
  14. Febrifuge

    Febrifuge Grizzled Old Newcomer
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    It's as Basic as can be, pun intended. Mostly gloves and gauze. Some SAM splinting stuff. An airway or two, some wound cleaning fluid, I think some roll gauze, and honestly the most versatile and helpful thing is the cling wrap from the grocery store. That stuff can be strapping, it can be packing, and heck no it's not sterile, but what is, on the roadside?

    The Dixie EMS one sounds way cooler, honestly.
     
  15. leviathan

    leviathan Drinking from the hydrant
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    Ohhh, ok. I've got the same kit myself. I thought you were referring to a kit with O2 tank, BVM ambu-bag, suction, airways, trauma pads, trauma shears, penlight, stethoscope + BP cuff, glucose, etc. etc. and then the rest of the basic first-aid stuff (bandaids, sterile gauze, etc.)
     

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