DickyV

10+ Year Member
5+ Year Member
Jun 20, 2007
211
0
Sleep - that's where I'm a Viking!
Status
Medical Student
I woke up today and noticed that I have a small (4-5mm) cut on my middle finger, almost like a paper cut. I'm on surgery now, and am wondering if it's still appropriate to scrub in, or would it be better for me/patients if I just observed cases.
 

Rendar5

15+ Year Member
Nov 12, 2003
6,999
625
Florida
Status
Attending Physician
...scrubbing kind of involves you putting 1-2 layers of gloves over your hand...
 

ZagDoc

Ears, Noses, and Throats
10+ Year Member
Jul 12, 2007
1,411
24
Status
Resident [Any Field]
If you're really worried about it, the circulating nurse should have some glue (forget what its called) which they use for open abrasions, cuts, etc when you have to scrub.
 

Pinner Doc

drop knees, not bombs
10+ Year Member
7+ Year Member
Jan 31, 2006
577
6
Status
Attending Physician
If you're really worried about it, the circulating nurse should have some glue (forget what its called) which they use for open abrasions, cuts, etc when you have to scrub.
Are you thinking of dermabond?

Are you concerned because you might have this cut from work-- scalpel/needle stick?
 

The Angriest Bird

10+ Year Member
Sep 24, 2007
424
6
Status
Resident [Any Field]
1. Check with your attending. Two reasons: 1) he has the best answer due to experience 2) make sure he's not pissed because he thinks "this guy isn't scrubbing for a little cut on his finger? wtf..." Surgeons can be very weird sometimes

2. My institution has an inflexible policy saying that "no med student scrub in on HIV, HCV positive patients", because we are not covered by the insurance. Check with your school for this.

3. Much more likely than not, you should be fine. The skin is epithelized after 24 hours and is impermeable to most pathogens, not to mention that you have 2 layers of latex gloves on top of that.
 

veenut

10+ Year Member
Jun 16, 2004
684
2
Status
Yup, that's the stuff. My mind grows vacant after 15 hour days...
From what I've heard, Dermabond is actually pretty expensive so I don't know if they would be very excited to waste it on a med student paper cut injury
 

Instatewaiter

But... there's a troponin
10+ Year Member
Apr 28, 2006
6,052
2,088
Washington
Status
Attending Physician
Get them to give you a tegaderm (?sp) before you scrub and double glove if you are worried about it.
 

45408

aw buddy
10+ Year Member
7+ Year Member
Jun 14, 2004
16,976
47
Status
Resident [Any Field]
You're wearing gloves. You'll be fine. I suppose you could ask the attending anyways though.
 
OP
DickyV

DickyV

10+ Year Member
5+ Year Member
Jun 20, 2007
211
0
Sleep - that's where I'm a Viking!
Status
Medical Student
2. My institution has an inflexible policy saying that "no med student scrub in on HIV, HCV positive patients", because we are not covered by the insurance. Check with your school for this.
I'm wondering - do the hospitals at which you work test every patient for HIV and HCV? If not, are you covered for cases where patients have the disease but don't know it?
 

The Angriest Bird

10+ Year Member
Sep 24, 2007
424
6
Status
Resident [Any Field]
I'm wondering - do the hospitals at which you work test every patient for HIV and HCV?
No. Does that mean that we are constantly exposed to undiscovered pathogens, both airborne (TB, H1N1) and blood-borne (HIV, HCV)? Yes.

If not, are you covered for cases where patients have the disease but don't know it?
In our institution, you have to call a number immediately if you have a needle-stick injury. There are some paperworks to fill out, which bypass the informed consent and will allow the hospital to draw blood from the patient and test for stuff like HIV. And the affected medical student will get treatment, such as prophylactic HAART, for free. I don't know if you are covered if you sero-convert and become HIV-positive chronically. Fortunately, nobody so far in my school has sero-converted yet.
 

cpants

Member
10+ Year Member
Sep 28, 2007
2,656
291
Status
Attending Physician
Get them to give you a tegaderm (?sp) before you scrub and double glove if you are worried about it.
This is the answer. Put a small tegaderm over the cut and then scrub as normal. Single gloves are fine for most med student scrubs, but if the patient is hep or hiv positive or if you are just nervous, double gloves are appropriate. In the event of a stick, the superficial glove will remove most of the patient fluid before the deep glove is breeched.