Needlestick last night from +HepC pt

Advocate1 · Jan 27, 2008

My thoughts and prayers are with you. You did the right thing by going to the ER stat. this is difinitely a scary situation to be in. I hope the test results are ok.

Dancin'Mom · Jan 27, 2008

I've heard the chances of contracting Hep C are pretty small compared to Hep B. I actually stuck myself with a butterfly needle along time ago from a patient that had HIV PCR testing ordered. I was completely scared and went to the ER , took the prophylaxus drugs, then found out he was HIV neg and the wrong test was ordered on him. That was one of the worst weeks of my life. Anyway, I know you are scared but the chances are pretty small that you've contracted it. It is a scary thing that nurses put their lives pretty much in danger on a day to day basis taking care of patients. It is the risk we take. We can just try and use standard precautions and do our best. The rest is in God's hands. You will be in my prayers.

core0 · Jan 27, 2008

hello everyone, i'm a second-year rn student in an adn program, so this is my last semester. we just started clinicals again and last night i gave an insulin shot to a +hepc pt, was wearing gloves, *forgot* to push the safety up to cover the needle, walked over to the sharps box, went to drop it in, and it stuck to my glove somehow so that when i went to let go, the needle flew out to the side and stupid stupid me my left hand reflexively went up and of course, got stuck.
this was probably only my 3rd insulin shot i've given, my instructor was not in the room, and honestly i was nervous about this pt anyway because he was a cranky guy who obviously did not like being cared for by a student. i told my instructor right away, went down to the er and got tested. the pt agreed to a hiv test, but the results aren't back yet. i feel badly that this guy might have this on his conscience, and
i am sick over this. absolutely sick. i have a wonderful husband and 3 gorgeous children; firstly i am scared to death that i contracted anything, but also i am sick with the thought that i may give something to my family.
please, anyone, any help, kind words, or advice will be appreciated.
thank you so much.

here is the cdc information on healthcare workers:

what is the risk for hcv infection from a needle-stick exposure to hcv contaminated blood?

after needle stick or sharps exposure to hcv positive blood , about 2 (1.8%) healthcare workers out of 100 will get infected with hcv (range 0%-10%).

what are the recommendations for follow-up of healthcare workers after exposure to hcv positive blood?

anti-viral agents (e.g., interferon) or immune globulin should not be used for postexposure prophylaxis.

for the source, baseline testing for anti-hcv.
for the person exposed to an hcv-positive source, baseline and follow-up testing including

* baseline testing for anti-hcv and alt activity; and

* follow-up testing for anti-hcv (e.g., at 4-6 months) and alt activity. (if earlier diagnosis of hcv infection is desired, testing for hcv rna may be performed at 4-6 weeks.)
confirmation by supplemental anti-hcv testing of all anti-hcv results reported as positive by enzyme immunoassay.

should hcv-infected healthcare workers be restricted in their work?

no, there are no recommendations to restrict a healthcare worker who is infected with hcv. the risk of transmission from an infected healthcare worker to a patient appears to be very low. as recommended for all healthcare workers, those who are hcv positive should follow strict aseptic technique and standard precautions, including appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments.

the full page can be found here:

http://www.cdc.gov/ncidod/diseases/hepatitis/c/faq.htm#1h

personally i feel that the guidelines are somewhat outdated. with good qualitative or good quantitative rna testing you will show a positive results much quicker than antibody testing. in my former practice we did hcv rna testing qmonth x six months. at this point it is unlikely that you will get hcv. that being said the risk is less than 2% for needles according to the cdc.

david carpenter, pa-c

FireStarterRN, BSN, RN · Jan 27, 2008

Your chances of getting this, especially from a sub-Q needle, are very low. Try to set your mind at ease.

LogCabinMom · Jan 27, 2008

Thanks, all. I just got news that the patient was HIV-, so TG for that... now I just have to wait and see about the HCV... I know it's not always a death sentence, but it's not something I'd like to have on board, either...

LogcabinMom

core0 · Jan 27, 2008

Thanks, all. I just got news that the patient was HIV-, so TG for that... now I just have to wait and see about the HCV... I know it's not always a death sentence, but it's not something I'd like to have on board, either...
LogcabinMom

Hopefully they also checked for HepB? Also it is helpful to do a HCV RNA on the patient as you can somewhat predict the chances of getting infected by the viral load. This can be good and bad (ie higher viral load = higher chances of infection in some studies).

David Carpenter, PA-C

LogCabinMom · Jan 27, 2008

My instructor just called and was wondering the same thing... I'm not sure if they've done a HCV RNA or not... I know his LFTs looked very good, but that's it.. Another question for the Occupational Nurse at the hospital.

I've had my HepB series, and a titre so I am immune to that.

CRNA2007 · Jan 27, 2008

It takes quite a bit of blood exposure to contract hepatitis C so if it was a needle stick I would get checked out to put your fears to rest.

core0 · Jan 27, 2008

It takes quite a bit of blood exposure to contract hepatitis C so if it was a needle stick I would get checked out to put your fears to rest.

While the chance of acquiring HCV is directly related to the amount of blood exposure, viral load, and exposure method it never approaches zero. It is good practice to get checked out and do regular surveillance for six months. The chance of conversion does remain about 2% which is low.

David Carpenter, PA-C

Nursebarebari · Jan 27, 2008

My dear fellow nurse, I understand how you feel and you are in my daily prayers. A lot of the patients we treat at my job are junkies, so we see a lot HIV/AIDS, hep A, B, C, D. patients. It happened to 4 of my co-workers over the years and none of them got infected after the treatment. I'm sure you, just like my co-workers will come out clear. Just try and take it easy.

LogCabinMom · Jan 28, 2008

thank you everyone, you've really helped my worries...