Surgeons and needlesticks

[DuneHog]

I am a 3rd year doing my surgery rotation and I am surprised at how often surgeons are stuck by sharps during procedures. They usually just ignore it. In fact, I have never seen one go to the ER and go through with the needlestick protocol.

Why aren't surgeons more concerned about contracting a bloodborne disease? I know that HIV is rarely contracted by needlesticks, but Hep C is a major threat. Has anyone ever looked at what percentage of surgeons are hep C positive?

I am considering surgery, but I do not want to end up with cirrosis, hepatocellular CA or a liver transplant when I am ready to retire.

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[Jova]

You don't have to end-up with Hep C. You can be extra cautious. You can be a surgeon!

Here are some things to consider:

1. Double glove! (or triple if you know your patient is a carrier)

2. Good surgeons should always maintain control of the needle. Sure there is a learning curve and mistakes do happen,--but unless the patient is moving, why would one get stuck with the needle on a continual basis?

3. The needle should be passed with the tip enclosed in the driver. Not everyone does this. If a team works together regularly that might not be necessary but at least one should say, "needle" when handing it off.

4. I have not seen every surgery that exists, but from the many I've seen, it has never been necessary to actually handle the needle. Use your instruments!! (Maybe OBGyn when they use those strait sewing needles and central line kits with the strait needles--but you can always use instruments instead.)

5. Most surgeons who are performing elective procedures know about their patient's past medical history and risk factors for Hep. and other diseases. If a stick were to occur they may not be concerned because of the known low risk. Also they can order blood tests on their patient later if they want to know for sure, but this is probably unlikely.

6. I am pretty sure if someone gets "stuck" during a case, they are considered contaminated and should re-glove.

7. There have been a few cases here and there of surgeons contracting diseases from patients (mostly dentists/oral surgeons before the standard use of examination gloves). However, for the most part, your career choice will not kill you because of an infection.--This would be widely researched and known by now if it were a problem unique to the surgical field. However, if you are concerned about your future health, look into heart disease secondary to increased stress, poor sleep, and eating habbits.

8. Most importantly, practice safe technique! Just because others get lots of needle sticks doesn't mean that you have to.

Good luck! Do post your observations.

 

[tussy]

If a surgeon were to contact Hep C, or HIV he/she would be not allowed to practice surgery (both legally and morally), because of the risk of infecting your patients. Most surgeons who get stuck are unwilling to go thru with the standard needlestick protocol because it usually involves the person being stuck having their blood tested as well.

I was stuck just a week ago from a high risk patient. I didn't go thru the standard needlestick protocol, but did get someone else to get permission from the patient to send off his blood. I called the lab the next day and got the results (negative, thank god).

The above poster is right though - there are many things you can do to avoid sticks and they have listed the common ones above. We should all be more careful.

 

[Spidey]

Yikes, that must be scary... Most surgeons must dread the idea of operating on someone who is HIV positive... getting stuck while operating like that would be the stuff of nightmares.

 

[tussy]

ACtually, I'm more afraid of Hep C than I am of HIV. The chance of contracting HIV from a hollow bore needlestick from a know HIV + is about 0.3%. The chance of getting HepC from a needle stick is almost 40%. If you get stuck with an HIV needle there are prophylactic drugs you can take -- there are no prophylaxis for Hep C. HepC is also much more common than HIV.

 

[andy toth]

yeah, like in final fantasy: the spritis within: dr. aki didn't want to be scanned because she had the gaia virus component inside of her system. she got this other guy to get her deferred from scanning. but if she would have been scanned like the others, her project would have been totally over.