exposure!

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Specializes in Telemetry, ER.

I have a quick question. Anyone out there have a run in with a HIV pt and exposure via splash-back on the face? I was collecting blood and there was to much pressure in the tube and the top blew off. I didnt feel anything go into my eye and I have known what that feels like before. I froze and immediately ran to the bathroom. I saw nothing in my eye and had a small pin point drop on my cheek. There was a few tiny dots on my nametag, and that was it. The rest of the splatter was in front of me on the bedside table. I washed my face and outs out very well. Because the pt is confirmed HIV I am afraid that I may have to take the meds as a precaution. But, my exposure risk is really low because my mouth was closed and I saw nothing in my eye. I guess I am just looking for anyone with any experience with this and any advice. They say exposure through mucous membranes is 1 in a 1000. Any thoughts?

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Specializes in Utilization Review.

I think I would have reported the incident to employee health so it can be documented appropriately. They can decide whether the exposure is considered high risk and treat accordingly.

And it's always best to do this as soon as possible after the possible exposure. :twocents:

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I agree. It's always best to report anytime you have any concern regarding exposure.

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Specializes in Emergency.

I want to know how the pressure from a pt's vein blew the top off a vacutainer. Personally in 20 yrs I have never seen it happen. I do see it happen when nurses use syringes to push blood in to tubes however. Hence maybe no mention of being reported.

As to risk who knows, that depends on the pt's viral load, the amount of exposure. Just because you didn't feel something go in your eye doesn't mean something did not. By the time you got to the bathroom to look your eye already self cleaned.

Rj

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Specializes in Telemetry, ER.

It was a pediatric tube, we use those in our ER for peds and pts who we cant get enough blood out of. I was using a transfer device, which is our policy. And I did report it to employee health (hence why I was scared that I may have to take the meds eventually) I was simply looking for some advice on anyones experience on this matter. Really appreciate the help in this scary time in my life, thanks.

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I have had a similar experience a few years ago... exposure that is. It may be a good idea to talk to someone who knows a great deal about occupational exposure. It can be sooo scary, but talking to an expert will probably ease your fears. The thing is... HIV virus dies within less than a second if it does not infect a cell. Also, the amount of actual exposure is variable depending on the viral load, and amount of exposure to blood. Usually, occupational exposures are not great enough to successfully transmit the virus-- that is what I've been told. If you are talking about a drop---

**** AlSO, I know that antiretrovirals need to be started within 24 hours to greatly reduce your risk-- after a few days I think most exposures don't get treated because it is ineffective.. I decided not to do it because of the very low risk- and 2 years later no problems. I think the most important part is the incident report and baseline bloodwork.

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Specializes in Telemetry, ER.

Nursin09,

Thank you so much, I cant tell you how much just hearing what you went through has helped me. I to decided to not take the antivirals, because the risk was low, and plan on following up with my own GP. But you are right, the whole thing is so freaking scary and all the paperwork, blah! I can guarantee I'll be extremely careful in the future. I really appreciate you sharing your experience with me, thank you!!

:urck:

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Blood contact on intact skin is not considered to be a vector for exposure. For mucosal exposure, the risk for HIV transmission is estimated at about 0.09%.

http://www.people.vcu.edu/~gbearman/Adobe%20files/Bloodborne%20Pathogen%20Exposures.pdf

Scary experience, tough decision. Good luck.

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Following a mucocutaneous (via the mucous membrane) exposure the average risk is estimated to be less than 1 in 1,000.

http://www.aidsmap.com/en/docs/F661F15A-FDD7-41FF-80FA-8FF0F61A18D2.asp

Hope this helps.

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It was a pediatric tube, we use those in our ER for peds and pts who we cant get enough blood out of. I was using a transfer device, which is our policy. And I did report it to employee health (hence why I was scared that I may have to take the meds eventually) I was simply looking for some advice on anyones experience on this matter. Really appreciate the help in this scary time in my life, thanks.

Back in the early 90's I was sprayed directly in the eyes with blood from an AIDS patient. I went through the serial testing (no prophylactic meds offered at that time) and everything turned out negative. The risk is infinitesimal, but it's still scary.

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Specializes in Theatre, HIV/AIDS.

I know how you feel. I spent time working at an HIV/AIDS centre last year, and even though I had no exposures I still have little freakouts sometimes. Tell Infection Control and get tested - now, and again in three months. Wear protective gear if this is a risk when taking blood the way you do in your facility. And do something nice to take your mind off it.

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Please, dear friend, use a face shield from now on. If your facility does not supply them, get your own and get your facility up to date. Are they used in the OR at your place?

I am praying that you feel at peace and that your fears will all be groundless.

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