Is this considered exposure?

PageRespiratory! · Nov 27, 2007

Technically speaking, intact skin is considered an effective barrier. However different institutions have differnent definitions of "exposure". You might want to check your employers policy. I feel its better to be safe than sorry.

TazziRN, RN · Nov 27, 2007

I would not consider that an exposure but the facility might have a different definition.

flightnurse2b, LPN · Nov 27, 2007

i would check with your nursing supervisor... i think it would be better to fill out an incident report just to be safe...

EmmaG, RN · Nov 27, 2007

i would check with your nursing supervisor... i think it would be better to fill out an incident report just to be safe...

I think one should be filed. If it turns out to be unnecessary, no harm done... but if it isn't filed and something does come of this at some point down the line, she'll have no record of the exposure and probably no coverage under WC if any treatment or followup is needed.

Elvish, BSN, DNP, RN, NP · Nov 27, 2007

I had nearly the exact same thing happen to me as a newbie. I had a pt whose AV access ruptured (it was abscessed and to be repaired in the AM) who had HIV. I ran in and without thinking about it slammed my bare hand down on top of his bleeding arm. The pt (very sweet guy) yelled at me & told me to go put on some gloves while he held pressure.

I filed an incident report but OH at that facility didn't consider it an exposure. I'd still file a report if there's any doubt. My skin was intact and everything was fine.

Xbox Live Addict · Nov 27, 2007

At my work, exposure is gauged in terms of "source" (whether the source of the blood/fluids was known to be negative, positive, or unknown test status) and "port of entry." In order to be a high-risk exposure incident, both the source and the port of entry have to be high-risk. If either one is low-risk, it is a low risk exposure. Check with your facility's official policies, and err conservatively if you have any doubts.

Low-risk source - known negative test status

High-risk source - known positive test status or unknown test status.

Low risk port-of-entry - intact skin

High-risk port of entry - mucous membranes, eyes, breaks in skin

TrudyRN · Nov 27, 2007

File an IR, keep a copy. They tend to get "lost". What if she gets sick later? They'll try to deny her WComp claim for her not filing an IR.

tvccrn, ASN, RN · Nov 27, 2007

How does she know her skin is intact? She's a nurse and most nurses I know have dry skin to some degree. She may think her skin in OK, but there may be microopenings that she isn't aware of. To be safe, I would treat it as an exposure, that way she is covered in the future should something come up.

tvccrn

antidote · Nov 27, 2007

You should: ask your nursing supervisor

I would: file this as exposure. As a poster said above, we can't be too safe about micro-openings in the skin or something she wasn't aware of. Perhaps she just said that so no one would be worried about it and move on? I would have this filed as exposure and be sure to keep a copy.

classicdame, MSN, EdD · Nov 27, 2007

complete a variance report. If nothing else the process for preventing such an occurance ought to be reviewed. Better to be safe than sorry.

GeauxNursing · Nov 28, 2007

question for OP: bleeding out around the cath? like where it was inserted? you dont mean out the ports, right? makes me think of LifeSites. does anyone remember these? surgically placed ports into the chest for dialysis access? You punch the needles through the skin til they "click" into place in the LifeSite. i think they were banned or, they stopped making 'em. anyhoo, one pt just started bleeding out of his/her sites one day, I mean BLEEEEEDING. couldn't stop it. gauze after gauze after gauze. it was really scary. he/she finally clotted up after about 20 minutes. now has a graft in their chest. the COOLEST thing to stick. ever.

i digressed. oops.