Needlestick- Post Exposure Prophylaxis

[PaynRN]

Anyone every take the Post Exposure Prophylaxis for a needlestick?

I am a nurse in an outpatient pain center. I love my job except the doctor insists upon using un-shielded angiocaths due to cost factor. Yesterday, I got stuck emptying a trash can (someone accidentally threw the needle in the garbage). The stick was on the top of my hand near the knuckle with a 24G angio with blood in the hub of the device. Age of the angio and patient un-dertermined. There is a chance that the needle had been there over a day since that room does not get used that often and to me the blood in the hub did not look "fresh".

Of course I am very ****** that this happened. I am very careful with my used angio's and I haven't had a needlestick in more than 15 years.

It was at the very end of the day, everyone was leaving and I was left to deal with this mess on my own (finding our P & P, getting copies of everything, and finally going to the local ER)

I made it out of the ER 3 hours after the incident. The NP there had given me RX's of the 2 drugs 3TC and AZT. I could not make up my mind about starting the meds in the ER. Of course now after coming home and reading about them I find out that you are supposed to start within 2 hours post exposure which I was not told in the ER.

I come home talk to my sister that is also a nurse, call my nurse manager (who is on vacation) and decide that I would try the meds. I go to 2 different pharmacies to get the meds, I pay for 4 days worth of meds out of my own pocket because I didn't have Workers Comp info yet, and take my first dose 7 hours post exposure.

So here I sit in the middle of the night because I couldn't sleep. Already I feel funny and weird. I am mulling this over in my head trying to decide if it is going to be worth it. I am definately not a risk taker and am freaked out about the whole thing.

So my question is has anyone taken the meds and how were they tolerated?

Also, what would YOU do in this situation?

[chenoaspirit, ASN, RN]

Ive never taken them, but in your situation...I think you did the right thing by taking them because you dont know whose blood was in that needle. So there was no way to test their blood. I would have definitely taken them. Go and search the internet about side effects, etc. So sorry you are experiencing this.

[PaynRN]

So 2 doses in.

Side effects so far a burning feeling in my abdomen and some diarrhea. I am also a little dizzy.

[LGRN]

I am SO SORRY that you are going through all of this! You do not deserve this. I am one of the millions of nurses stuck every year. Yes, you are among so many. Unfortunately, I am the small minority who had a transmission from that needlestick injury. But, the numbers are with you and it is likely you won't have a transmission.

Actually, that doctor/employer is in violation of federal law. The employer HAS to provide safety devices. Does he/she not purchase car seats for their children because of the cost? Are police not issued bullet proof vests because of costs? Construction/hardhats. Firefighters/airtanks The list goes on.

There were many of us that although ill, worked EXTREMELY hard to get these laws passed so that our colleagues would never have to suffer what we are going through, and yet this turkey has the nerve to ignore federal law, and put your life at risk? Yikes! That makes me SO ANGRY! Shame on him/her!

This will never change unless we stand up for our rights to stay alive. Please educate your employer on their legal responsibilities to provide safety devices, to get your input on the choice of devices, and to train you on their implementation. Just providing WC insurance is not just inadequate, it is irresponsible, disrespectful and (expletive)!

Again, I am so sorry you are going through all of this and my thoughts are with you in this difficult, painful and scary time.

[TazziRN, RN]

I have had many needle sticks. Most of the time I elected not to take the meds, but only because the source pts were low risk. The few times when the source was high risk or unknown, I took no chances and took the meds. I felt horrible but I felt the side effects were worth it.

If I were you I'd be reporting the doc to OSHA and finding another job.

[LGRN]

:bowingpurAbout the meds: You are courageous and responsible for taking the meds! Denial is a wonderful place, but not real healthy!

I had a "low risk" stick. The patient was over 90 and you don't get that old with risk factors! My stick was after her IM injection. Low risk - right? Well, she had a few units of RBCs after her hip replacement a few days before. The donor was in a serolatent stage so the blood made it through the screening process with no detectable antibodies and a very high viral load. My poor patient died a few months later and I converted and have been real sick.

Point: There is NO SUCH THING as a low risk stick. None. Nada. Zilch.

Lets make thing better. That's what nurses are good at so let's just do it!