Scrub with cut on finger

[DickyV]

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.

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[Rendar5]

...scrubbing kind of involves you putting 1-2 layers of gloves over your hand...

 

[ZagDoc]

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]

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]

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.

 

[ZagDoc]

Are you thinking of dermabond?

Yup, that's the stuff. My mind grows vacant after 15 hour days...

 

[DickyV]

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

Thankfully, no - I'm the type who would go running to the exposure packet if I even thought that a sharp looked at me the wrong way.

 

[veenut]

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

 

[Rendar5]

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

it's just a form of superglue

 

[Instatewaiter]

Get them to give you a tegaderm (?sp) before you scrub and double glove if you are worried about it.

 

[45408]

You're wearing gloves. You'll be fine. I suppose you could ask the attending anyways though.

 

[DickyV]

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]

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.

 

[veenut]

it's just a form of superglue

Not arguing with that, but I've been told it's very expensive

 

[cpants]

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.