I am a regular lurker here (hope to someday work in OR) and wanted some insight as to how often needle sticks happen in the OR. I've heard the most likely places for needlesticks to occur are in the ER and OR. Any thoughts on this?

LOL, I've only had 2 in 30 years--both times, a surgeon inadverdently stuck me with a used suture needle, on a needle driver, as he was handing it back to exchange it for a fresh suture--without looking up. One time, the patient had active Hepatitis C. It was an accident--I didn't get mad, or anything--it's a risk of what we do--in other words, it comes with the territory. I didn't get Hep C. I had had my shots, and I seem to recall that I had to get more--in fact, I don't think that there IS one for Hep C, come to think of it! Only a series for Hep B. Anyway, we are all pretty careful, and hardly anyone uses #11 blades anymore. They used to be a big culprit in actual lacerations when dropped on a hand or a foot--in fact, I've had one, to a hand, so that makes a 3rd high risk exposure, except it was in the pre-AIDS era.

When we know absolutely, positively that a patient has known Hepatitis, AIDS or even is an IV drug abuser, we often exchange sharps back and forth in an emesis basin--our hands never touch the sharp, at least at those points in the surgery. This would probably be the way to approach ALL surgery, but, in reality, we don't do it that way for ALL cases.

our best-practice guideline is to double glove, but of course, people do that according to preference...you can still single glove if you choose. double gloving with the sensor/green lets you see if your glove is compromised. half the time, i have not felt getting stuck with a needle, but saw that the outer glove was compromised, and just changed out my glove. there are so, so many sharp things between suture, blades (of which there are varying degrees of sharpness), bone chips, cobbs, elevators, etc. i'm as careful as i can be, but i did slice my thumb with a weck blade just before christmas. luckily, it was totally new and clean. the blade guide was bent, and of course, i had to try to get it on the handle again, and ouch... 5 stitches later, i was a circulator for the next 10 days. so...needle sticks happen, among other things "sticking" you.

I have been stuck a few times in 28 years, mostly in the beginning before AIDS or Hep C. I didn't do anything about it then so I don't know if one of these days I might get something. I doubt it. The sticks I have had over the past few years were always with a "clean" needle. Totally we get 2-4 sticks a year in the OR and have had no post-stick problems. I don't double glove because my hands tend to fall asleep if confined too long. Mike

II don't double glove because my hands tend to fall asleep if confined too long. Mike

Same here; exactly---I've never double gloved, and, if a facility required us to do it, I'd quit.

You know, some people are so freaked out about getting some disease--not even a blood borne disease-- that they carry things to ridiculous and expensive extremes. For example, I've seen residents and transport orderlies double glove--with STERILE gloves, mind you, citing that the cheap disposable gloves "don't fit," simply to transport patients--afraid of getting some exotic germ off the gurney. Why not simply wash hands well upon completion of transport, as they should be doing ANYWAY?

Yet I see these same residents and transport orderlies at the gym doing arm curls and triceps extensions, sweating all over the Nautilus arm pads and handles--just as multiple people prior to them have done. This is when they should be thinking of the possibility of picking up community acquired MRSA--and perhaps disinfecting the pads, or at least laying a towel over them, before they start working out--but this never occurs to them. I just have to laugh when I see it, but you can't tell these macho guys anything.

Ditto for starting IVs--some nurses and residents double glove with STERILE gloves before they'll do IV access or draw blood. Or, they don sterile gloves to pick up and/or bag used raytex and laps. Why not just invert a plastic bag over one's hand and pick up the sponges that way--or with a sponge stick, then transfer them to the plastic bag? We waste entirely too many sterile supplies in the operating room in the name of "safety," IMHO.

Thanks for the responses. I'd never thought about getting stuck with things other than needles and blades (ie bone chips). I'm glad to hear it doesn't seem like it is as common a thing as I'd heard, although I'm sure the likelihood increases in the chaos of an emergency situation. Maybe as you are working with so many sharps it is consciously in your head to be so careful. I had a needle stick on orientation at my first job while being extremely nervous and trying to start an IV. Hope it's my only one!

I double glove anyway because i get hangnails, and for various other reasons. A surgeon (same one) has stuck my outer glove with a suture twice in 10 months.

I double glove anyway because i get hangnails, and for various other reasons. A surgeon (same one) has stuck my outer glove with a suture twice in 10 months.

Marie: Just curious, how do you respond in this type of situation? I realize that this is a risk of the job, but if something seems to be happening repeatedly the same surgeon would you bring it up to him?

what is the sensor/green?

what is the sensor/green?

these are part of a biogel (brand name) system of double gloving. http://www.regentmedical.com/americas/gloves_product_listing.html

you wear the green glove as the under-glove, and the sensor glove (which is a white color) on top. when any sort of fluid gets between the gloves (as would happen if your white sensor glove was broken in any way) the green pops out at you...you can't miss it.

I wear the Biogel undergloves with the Protegrity gloves. If i wear the Biogel Ms with the greens, i don't see the green as well.

Marie: Just curious, how do you respond in this type of situation? I realize that this is a risk of the job, but if something seems to be happening repeatedly the same surgeon would you bring it up to him?

If it happened again, i would bring it up to him. Both times, it was an accident. First time it happened was in August, second time, February.

thanks for the responses. i'd never thought about getting stuck with things other than needles and blades (ie bone chips). i'm glad to hear it doesn't seem like it is as common a thing as i'd heard, although i'm sure the likelihood increases in the chaos of an emergency situation. maybe as you are working with so many sharps it is consciously in your head to be so careful. i had a needle stick on orientation at my first job while being extremely nervous and trying to start an iv. hope it's my only one!

many of the instruments are sharp, particularly things that are made to shave off bone (like elevators) and the smaller things, like the tips of micro-bipolars, can be pretty sharp simply because they're tiny.

i think that accidents happen when the system for safety breaks down (when you're in a hurry, there are new residents in the or, new equipment, fatigue, etc.) or when there's a malfunction in the equipment. when i cut myself on that weck blade, i'll admit i felt rushed by the residents who were not enamored of cutting down the burn on this patient. burn cases have notoriously sharp and dangerous blades. between humbees, dermatomes, and wecks, and...add to the dirtiness of burns...working quickly to minimize the time the lower dermal layers are exposed...potentially huge blood loss, things are slippery from the blood and mineral oil: the potential for mistakes in sharps handling increases. i learned to take my time and follow through on my safety checks. i also learned that if the darn blade guard won't slide on easily, chuck it and go on. i am not going to cut myself again. :)