Be Careful Out There

[debbyed]

We all Know what we are supposed to do, what is safe and what is right but sometimes those lines get blurred and we don't think before we act, especially if there is an infant involved.

The other day a woman WALKED into the waiting with a limp 6 week old infant in her arms. The first nurse to reach him observed the infant was not breathing, yelled for help and immediately started mouth to mouth.

Now if that had been an adult all of us would have screamed for help and opened the airway while waiting for an ambu bag to arrive. This however was a tinny tiny baby so the nurse started mouth to mouth and ran back to the code room.

I guess most of you can figure where I'm going with this. After we coded this infant for a very long time and were unsuccessful we called the code. Upon telling the "mother" (who was in the room the whole time but didn't seem the least bit concerned or upset) she informed us that she was only a foster mother and she had only received the baby yesterday but she hadn't expected him to die so quickly. That of course perked every one up because we had been yelling questions at her the whole time and had no idea the child was sick... The woman's response was "Oh, he wasn't sick but he had AIDS"

That was a wake up call none of us expected. As professionals we are all aware of the dangers around us but before this I never really associated those dangers with a 6 week old infant. Until this time it would have almost seem to be inhuman to pick that child up and run, not doing resus until you got that infant ambu bag (even though we were all taught differently at some point in time). Now we all know better. Most of us would have expected a caregiver to tell us immediately about the childs condition but apparently there are some who really don't think (or care) about others safety. The "mothers" behavior probably should have clue'd us in but nobody was really paying attention at that time. We saw all this in hindsight.

We have a good exposure plan at our hospital and the nurse was treated quickly and efficiently but there is still that little black cloud that has everyone thinking, whats happening to our world.

Sorry I got carried away but I wouldn't want any other medical professional to make the same mistake my co-worker made (and had it been me I also would have made). Just be careful out there, many dangers hide well.

[BadBird, BSN, RN]

Wow, how sad, to lose a baby, fear for your co worker. Thanks for sharing, it definately openend my eyes wider.

[canoehead, BSN, RN]

I feel for your coworker.

I think the risk is worth it- if someone hands me a limp baby I wouldn't be able to live with myself if I didn't do everything. Even if he/she was HIV+. Stupid foster mother should have said the baby was DNR, and HIV+. People are so thoughtless.

[webbiedebbie]

Makes me think I should be carrying a mask with me at all times just in case.

[New CCU RN]

That is very sad, both the loss of the infant, the suffering the infant had to endure, and the potential exposure your coworker experienced.

Fortunately, even though she performed mouth to mouth, the chance of transmission is still very slim. I cannot give you an exact stat but I know that a large bore needle stick is somewhere around 1% chance of transmission. Mucous membrane exposure is generally less, although she obviously had an increased amount of time exposed to the HIV than your typical exposure.

Your exposure team should be able to get her the stats, but do know that they still are quite low. Maybe that will help ease her worries.

It is quite a wakeup call, and very scary. I think I probably would have done the same thing.... what is unfortunate is that the foster mother didn't explain the situation to the nurse. That would have obviously been quite helpful.

Saying a prayer for your friend and the baby.

[Rav_810]

Thank you for telling the story what happened. Sad to hear the baby died, i hate hearing little infants die. It's a wakeup call to all of us in the profession or entering it, there are dangers around. I mean no one thinks twice when it comes to saving a little infant, but we have to remember that there are dangers around. The foster mother should have informed the staff it was Hiv+ anyone with a little common sense would do that. I hope the nurse that gave mouth to mouth is ok. I am currently at university, this is something to really think about. Again thakyou for sharing the story.

[caroladybelle, BSN, RN]

Large bore needle stick - less than 1/3 of 1% chance of HIV transmission.

Hepatitis B transmission - substantially higher - chance of getting HepB and dying of it or HepB related problems much higher than chance of HIV transmission.

HepB has always been a major killer for health care workers - Has the child been checked for that?

[gwenith, BSN, RN]

It is always difficult to deal with the death of a child especially under truamatic circumstances. Even a stranger child that you do not know. You and your fellow co-workers have my sincerest thoughts and wishes.

[renerian, BSN, RN]

I have been there. In the throws of a mess with any person I have done things to help save a life. Poor kid. Poor worker.

renerian

[debbyed]

Thankyou all for your thoughts and concerns.

[ernurse4life]

sorry to hear about your co-worker, but i probably would have done the same. it's amazing how many people don't think that hiv/aids is an "illness" just like BCPs are not a "medicine". i hope your co-worker will be fine.

[sanakruz, ADN]

Wow this is sad-

Let us know the outcome for your freind . I too believe there is a low risk