Two ?'s: Blood Exposure, then Coumadin INR & bleeding

  1. I got a needlestick yestereday from a stinkin' Lovenox needle when the safety mechanism refused to engage. I continued to press the plunger, but the pt had great ascites and complained of great discomfort. I pulled the needle out and it flipped over in my hand and stuck me superficially in the base of the opposite thumb.
    Went to employee health, did all the stuff. The pt, an elderly lady, tested negative for all the bad diseasees. Had been tested for some of them previously for other reasons. But repeats were the same.
    My question is this: She got a lab back today, VRE of the urine. Is there any chance of me getting VRE from the stick? I don't think so, but this sort of thing makes me paranoid. It's bad enough having to tell my hubby that we have to have safe sex for the next six months.

    Second question. Same pt is on Lovenox BID and Coumadin 12 mg dly. She bleeds from everything. She has no hematuria or fecal blood. BUT her skin is a mess. She has a skin tear of less than half an inch in length and it bleeds through four fluffs, an ABD and entire Kerlix wrapped around her very small elbow in less than two to four hours. She had a Picc placed and is still bleeding from the insertion site. She is bleeding from a 10 day old surgical site. Changing the bloody bandages and bed four to six times a day. Doc says INR not therapeutic, is 2.3, he wants 2.5 for artifical heart valve. But she is just a bloody mess all day long. He finally let me hold the Lovenox for today and tomorrow. Is it really necessary for her to go through this?
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    About KaroSnowQueen

    Joined: Oct '02; Posts: 1,176; Likes: 764
    Medicare claims review for major insurance company; from US
    Specialty: 30 year(s) of experience in telemetry, case management