accidental fingerstick

RNwrong · Dec 31, 2010

I agree HIV is not a prion, and the ELISA test is a fast HIV test. It tests for the presence of HIV antibodies but does not confirm the actual presence of HIV. ELISA will always be used first if test is negative they will not use the Western Blot, if ELISA is positive then Western blot is used to confirm HIV presence.

In your case I would discuss your situation with a lawyer, I am sure any decent lawyer would jump all over this case to help you out. Telling you the test was negative with Western Blot was inconclusive is ridiculous.

Old.Timer · Dec 31, 2010

beyond unbelievable.......

if it were me, i would:

get on recommended prophylactic meds asap
contact an attorney asap
not even think about worrying about the hipaa aspect

couple of very random thoughts re funding for meds that might be worth exploring:

http://www.nurseshouse.org/ i stumbled across this info one time many years ago. i immediately remembered it while reading your post. i cannot personally vouch for the organization but they struck me as legit.
based on the info posted, i would certainly think that it would not be too difficult to find an attorney interested in the case. so many angles to pick from. if they think the case is really solid they may even be willing to take it on contingency, front the money now to cover your meds and include that amount as part of any settlement.

as a rule, i think our society has become far too litigous, however, in this instance, i would look for an attorney who would go for the jugular. it's outrageous.

here is info on nurseshouse found on their website:

welcome to nurses house, inc.

a national fund for nurses in need

who we are

nurses house is a nurse-managed, non-profit organization dedicated to helping registered nurses in need. our history begins in 1922, when nurses house began to offer nurses a place to rest and recuperate at a long island, ny beachfront mansion, donated by emily bourne. as times and needs changed, the property was eventually sold and nurses house became a national service program. click here to read more about our history and see memorable photographs of the original nurses house.

what we do

nurses house, a 501 © (3) organization, is directed by a volunteer board of directors and executive director. our mission is to provide short-term financial assistance to nurses in need as a result of illness, injury, or disability. and while it is often difficult for nurses to ask for help in their hour of need, they who live their lives giving "little unremembered acts of kindness and love" deserve extra special care. at nurses house, we remember... and we're here to help.

who we serve

the nurses we serve, known as guests, are a very diverse group, ranging in age from their 20s to 80s. diagnoses also vary from cancer and depression, to spinal fusion and multiple sclerosis. while some nurses house guests face short term illness or injury, others are permanently disabled. many nurses need funds to help pay for such basics as food, a car payment, or health insurance. some face imminent eviction. click here to read stories about some of the nurses who have received assistance.

SlightlyMental_RN · Dec 31, 2010

Ummmmmm......just sayin', but this is the same person that posted this thread a few weeks ago:

Gosh being a nurse is hard when you have - Nursing for Nurses

Where she talks about being yelled at by a DON that she wanted to meet, while the DON was in the middle of an inspection by the State.

It's a closed topic but interesting in light of the current drama.

DPSGraduateNurse · Dec 31, 2010

Ummmmmm......just sayin', but this is the same person that posted this link a few weeks ago:
Gosh being a nurse is hard when you have - Nursing for Nurses
Where she talks about being yelled at by a DON that she wanted to meet, while the DON was in the middle of an inspection by the State.
It's a closed topic but interesting in light of the current drama.

Hm, either A. the person's nursing life is indeed full of drama (get out of the career now while you can) or B. someone's having fun at our expense (spammer) :uhoh3:

dazyRN · Dec 31, 2010

This needs to be reported to the state board of nursing!!!!!

CRNA1982 · Dec 31, 2010

Seriously? I'm thinking that you must be joking with this post. And if you are joking (just so you know), this is not a joking matter.
Since when does the gauge of the needle matter in a needlestick protocol? Do you suppose for a moment (with your CRNA education) that an HIV prion could not be lodged in a small-gauge needle?

I don't consider myself an expert on infectious disease transmission.....But I have read the statistics on needlesticks (Specifically HIV related) If I remember correctly, isn't there a 0.3-0.45% chance of contracting HIV with a needlestick?.... If you feel the need to argue with me and belittle my education, please provide some evidence based explanations other than your "prion" lodging theory.

backatit2 · Dec 31, 2010

i think it's silly to debate whether it's a possibilit or not - there is ALWAYS a possibility. should she worry? well, it's easy to say "no" unless it's happened to you. i'd like to say, "don't worry - the chances aren't high," but if it were me - i'd be worried.

GLB_68 · Dec 31, 2010

This needs to be reported to the state board of nursing

The BON is to report unethical or unprofessional conduct and violations of the NPA. If this LTC or hospital had no needle stick policy then they should be reported to OSHA not the BON.

If the facility didn't follow policy then OP should call an attorney because she needs legal advice she can't get here due to TOS.

Belle Epoque · Dec 31, 2010

I don't consider myself an expert on infectious disease transmission.....But I have read the statistics on needlesticks (Specifically HIV related) If I remember correctly, isn't there a 0.3-0.45% chance of contracting HIV with a needlestick?.... If you feel the need to argue with me and belittle my education, please provide some evidence based explanations other than your "prion" lodging theory.

I don't think that's what she meant. She was clarifying that the gauge of the needle doesn't matter in a needle stick injury - whether it's a 23 gauge or a 19 gauge, a needle stick is a needle stick with the same chance of infection. So a prick is a prick - and she's right.

chiuli · Dec 31, 2010

I got a prescription for truvada after 13 days post exposure. Im confused because I thought these meds are toxic on the liver and kidneys and the doctor did not order any blood work. He ordered 20 doses which according to the cdc they recommend these prophylactics be taken for a month or until the patient comes out negative.

This patient had an inconclusive test and will likely be tested in 3 months if that happens.

My question is how long do you have to take the prophylaxis? Blood work?

Lastly, Im having a drug test for a new job. They will also ask me what kind of meds Im taking during the physical. My mother tells me I cannot take this medication. They will think that Im a w&&&e and they will treat me differently

CRNA1982 · Dec 31, 2010

I don't think that's what she meant. She was clarifying that the gauge of the needle doesn't matter in a needle stick injury - whether it's a 23 gauge or a 19 gauge, a needle stick is a needle stick with the same chance of infection. So a prick is a prick - and she's right.

Again...Please provide some evidence based information if you want to further discuss this matter.

American Journal of Infection Control: Volume 20, Issue 3, Pages 133-137 (June 1992)

Needlestick injury: Blood, mononuclear cells, and acquired immunodeficiency syndrome*

PhD Djamshid Shirazian12, MD Barry C. Herzlich12, PhD Foroozan Mokhtarian12, MD Giuseppe Spatoliatore12, MD David Grob12

Introduction: Because transmission of HIV to health care workers after needlestick injury has occurred mainly a result of deep insertion of large gauge needles, blood and viable mononuclear cells transferred after needlestick injury were measured.

Methods: Needles of 20 to 27 gauge were filled with HIV-1 seropositive blood and inserted through extracorporeal human skin or parafilm covering physiologic saline solution modified Drabkin's solution, or culture medium, or inserted directly into one of these fluids, to a depth of one third of the needle length (0.5 inch) for 1 second. Volume of blood transferred was measured by both modified Drabkin's method and by chromium 51 labeling of red blood cells. Transfer of viable mononuclear cells was measured by growth in culture medium containing autologous feeder cells.

Results: The volume of blood transferred from a needle passed through skin varied from 312±69 nl from a 20-gauge needle to 14±4 nl from a 27-gauge needle, as measured by modified Drabkin's technique, and from 404±80 nl to 12±3.1 nl, as measured by chromium 51 labeling of red blood cells. The volume of blood transferred from a needle passed through parafilm was twice that transferred through skin. The volume of blood transferred through skin was 40% that transferred directly into fluid not covered by any barrier; blood transferred through parafilm was 80% of that transferred directly. When needles containing blood were inserted into culture medium for 1 second in the absence of a barrier, at least one viable mononuclear cell was almost always transferred to fluid from all gauges of needle tested. Insertion of needles through skin prevented transfer of all viable mononuclear cells from only 3% to 5% of 20- to 23-gauge needles, and from 12% to 32% of 26- and 27-gauge needles. Parafilm was an even less effective barrier than skin. Insertion of needles through parafilm completely prevented transfer of viable mononuclear cells from no 20- to 23-gauge needles and from only 5% to 10% of 26- and 27-gauge needles.

Conclusion: The volume of blood transferred after needle insertion through skin for 1 second varied with the gauge of the needle and was 30-fold higher from a 20-gauge than from a 27-gauge needle. Variable mononuclear cells were transmitted after insertion through skin from more than 95% of 20- to 23-gauge needles and from 68% to 88% of 26- and 27-gauge needles. Parafilm was less effective than skin in reducing transmission of blood and viable mononuclear cells.

April, RN, BSN, RN · Dec 31, 2010

These questions would best be answered by the doctor who prescribed you the medication.