help! My g/f stuck herself...

[Malloy]

Hello all, I hope this is the right forum for this.

She is an ICU RN, ~1yr out of school. A few nights ago she messed up somehow and stuck herself in her thumb with a needle after drawing blood from a patient. (elderly man) I understand there are saftey devices that have dramatically reduced the number of these incidents. Anyways, they tried to get in touch with his family for permission to screen his blood...but they can not be found. She supposedly has to wait 6 months to know either way about HIV...

Aside from being worried about HIV, hepatitis or any other terrible thing that can be contracted, she is also worrying about this move jeopardizing her job.

As far as I know, she has had a flawless record, and is held in high regard overall. She is worried about this really hurting her reputation.

Do you have any insight on this? Are there any statistics out there that may set her at ease? I apologize for coming on here with this question (as I'm clearly not a nurse) but I wanted to do something to possibly make her feel better. Thanks in advance :)

[Malloy]

No kidding! I'm a business schlepp who had NO CLUE of what a 'nurse' really does. Hats off to all...we really need ya!!

Most people do not realize what a nurse's job entails. Or think of it as dangerous.

[KungFuFtr]

For all you stats fans...

Single needle stick:

Hepatitis 40% infection chance

HIV .5%

[Raven1970]

Exactly-before I was exposed I had no clue about HIV, Hepatitis other than a vague idea from nursing school. I was scared spitless. No one would look at me or talk to me or even tell me she was positve hor HIV. The most understanding people who helped me through that very time in my life and educated me was a group pf gay professionals in New York. I learned more from that experience than any other. I found out what the media does not tell you. HIV is a life changing event, but the risk is greater to contract Hepatitis. I met a lot of great people and thank them from the bottom of my heart. Unfortunately there is nothing on the market yet (or at least 3 or so years ago) to vaccinate for all the other groups of hep other than B.

[Raven1970]

oops-very scarey time...

[Malloy]

The risk of transmission after exposure to HIV-infected blood is about 0.3%, whereas it is estimated to be up to 100 times greater for hepatitis B virus (30%) and could be as high as 10% for hepatitis C virus.

http://www.ccohs.ca/oshanswers/diseases/needlestick_injuries.html

Hmm.

[dacryocystitis]

sorry i misspoke. the 0.03% chance is for mucocutaneous transmission risk. (when i replied before, I thought this was the percutaneous risk). Percutaneous expsoures to blood contaminated sharp objects is 0.32%.

for hepatitis C: "most studies place the transmission rate below 3%".

All of this was just taken from:

Mandell, Douglas, and Bennett's Principles and Practices of Infectious Diseases. Sixth Edition. Pages 3393 (HIV) and 3383 (Hepatitis C). Copyright date 2005. of course this is 2006, so maybe the numbers has changed slightly.....but this is the most recent edition I have.

sorry for the incorrect information above. I should have looked it up before I spoke. lesson learned.

[VegRN]

There is NO recommended post exposure treatment for Hep C. See the CDC link below for recs on Hep B and HIV.

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm

[kat911]

If our lab has blood we can test without patient permission. Your GF needs to find out what the patients history is, is there anything that makes him high risk. That is not fool proof but generally is accurate. We don't offer drugs to staff unless the history is suggestive of high risk. Contaminated exposure is unfortunately a part of the job. Not to be taken lightly and always reported. Unless it was a blatant and reckless accident there should be no repercussions.

[BSNtobe2009]

I also don't know why they told her she had to wait 6 months to be tested for HIV. On the CDC website, worst case scenerio, that if a patient, was indeed infected with HIV, that in most people, the HIV antibodies will show up in the majority in a few weeks from date of first infection. The rest will show up a minimum of around 3 months. Only in very, very rare cases will it take a full 6 months for HIV antibodies to show up from date of first infection.

So, I don't know why your girlfriend was told 6 months was the standard wait, because that seems to go against what appears to be current testing methods.

[Spritenurse1210, BSN, RN]

I had a needle stick. If she gets treatment right away and a hepatitis b shot right away, she will be watched (as far as blood screening goes) for up to a year after seh stuck herself. she should aslo be put on HIV proflaxis, which is where seh takes a bunch of anti-viral drugs to reduce her risk of transmission.

[ortess1971]

Well, I'm basing that on the fact I haven't been admitted anywhere in the last 15 years where they didn't make me sign one of those forms. Maybe it's a state thing. But they make me sign that form even when I got to the doctor's office and it's part of the routine paperwork. The ER's have it, and unless you are going to die in the waiting room, if you don't sign the form, they will refuse treatment.

Many places are changing the way they gain consent for testing a pts blood. The OR just got new consent forms that specifically state that if a worker gets stuck during the case, the patients blood will be tested for HIV/Hepatitis. Many places will test even if the pt says no..next time they draw labs, they'll just do an xtra tube.

[Malloy]

Thanks everyone :)