Ugly Needle Stick Situation

[docB]

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Check this out:
http://www.foxnews.com/story/0,2933,155020,00.html

Wow! Could you imagine 18 kids showing up in your ER for needle sticks? Every one has to get blood drawn and you've got to go over the whole prophylax vs. not speech with each set of parents. This would grind any of my ERs to a quick halt.

 

[fuegorama]

Check this out:
http://www.foxnews.com/story/0,2933,155020,00.html

Wow! Could you imagine 18 kids showing up in your ER for needle sticks? Every one has to get blood drawn and you've got to go over the whole prophylax vs. not speech with each set of parents. This would grind any of my ERs to a quick halt.

What would be the protocol here? The EM nursing line on this was always, "we can't confirm that there is counseling etc. in case of a +".
It seems more like a health dept. thing with the f/u issues.

 

[dchristismi]

Yow...

 

[docB]

What would be the protocol here? The EM nursing line on this was always, "we can't confirm that there is counseling etc. in case of a +".
It seems more like a health dept. thing with the f/u issues.

We have a protocol that we use for employees that involves testing the source, doing baseline testing on the pt and giving the initial antiretrovirals within 1 hours if indicated based on the CDC guidelines.
With people from outside the hospital obviously it's tougher because you usually don't have the source pt available and they seldom get there within the optimal hour timeframe. However, we will give the antiretrovirals if the situation calls for it.

 

[Scrubbs]

A lot of the hospitals in Philly are using the rapid HIV test (which comes back in about an hour), so you could counsel and refer appropriately if needed.

The scary thing about this story, is that when it originally aired, the school had told parents not to worry about it. They did not recommend testing/being seen by an MD. Smart, huh? 🙄

 

[sweetfynesse]

A lot of the hospitals in Philly are using the rapid HIV test (which comes back in about an hour), so you could counsel and refer appropriately if needed.

The scary thing about this story, is that when it originally aired, the school had told parents not to worry about it. They did not recommend testing/being seen by an MD. Smart, huh? 🙄

we have a similiar system in my hospital in NYC..rapid HIV testing with results in ~30 mins. we have a counselor explain the test, etc...and they're there to give the results....

ironically, i treated 9 elementary school patients with needlesticks last year...apparently a 10 yr old kid found a needle outside of the school and proceeded to give his classmates "injections." the kids didnt come in until 2 days after the incident and it wasn't difficult educate patients on prophylaxis vs not.....actually, it was a lot less stressful than trying to convince a mom why their child doesnt need abx for their cold...

 

[docB]

A lot of the hospitals in Philly are using the rapid HIV test (which comes back in about an hour), so you could counsel and refer appropriately if needed.

The scary thing about this story, is that when it originally aired, the school had told parents not to worry about it. They did not recommend testing/being seen by an MD. Smart, huh? 🙄

The way we use the rapid HIV is to test the source pt. It doesn't mean anything when done to the person that received the needle stick. In situations like this where you don't have the source pt we wouldnt do the rapid HIV at all. You can't test a needle. Also remember that you have to advise the pt on the Hep B immune globulin. Do any of you draw titers for Heb B?

 

[Sessamoid]

The problem is that here in California we can't force the source patient to submit to testing. Back when I was in Texas this wasn't a problem. If the patient refused a blood draw, we told them we'd just call the police to hold them down, and we'd get the blood draw anyway.

 

[Scrubbs]

Not sure exactly how they handled it initially (rapid vs regular testing), but one of the kids stuck came back HIV+... obviously not from the needle, but throws a whole new spin on things regarding what order the kids got stuck in...