Needle stick injury HIV positive

[cdernurse]

Dear fellow nurses,

I am a RN in an emergency room trauma hospital in Philadelphia, Pa. Last Saturday I was pricked by a needle. I was starting a 20G IV on someone. I advanced the needle, saw the flash of blood, withdrew the needle. The needle was capped and sitting on the bed. I went to hook up the vaccinator to retrieve tubes of blood, no blood was coming so I figured the vein blew and bandaged the area. I withdrew the catheter tip along with the vaccinator connected. I went to unscrew the catheter tip from the vaccinator and felt a prick. I removed my glove and noticed I was bleeding. I know that it wasn't the needle itself to prick me, since it was capped and I had it in my other hand. I believe it must have been the vaccinator. I immediately told my charge nurse and the process begun from there. The patient contested for testing, in which we already knew he was HIV positive. The rapid came back and it indeed was HIV positive. The patient stated he currently takes Genvoya for his HIV and apparently his viral loads are undetectable. I received PEP within an hour after the exposure. I am somewhat freaking out, because I am married and I am distressed on what the future could hold for my husband and I.

Any advice, statistics, stories from fellow nurses that have been exposure to HIV positive blood?

Thanks

[NurseCard, ADN]

I'm afraid I have nothing, but I do wish you all of the best. That has to be scary. ((hug))

[Cowboyardee]

The odds of hiv transmission after a stick from a needle contaminated with the virus is usually listed at somewhere between 2 and 3 out of 1000 sticks.

Hep c has similar odds. Hep b has substantially higher odds of transmission, but you have likely been vaccinated already. Anyway, i suspect your patient has been tested negative for hepatitis?

Make sure you are given a full course of post-exposure prophylaxis to minimize your risk.

Good luck, but i hope it makes you ferl better to know the odds are in your favor.

[nutella, MSN, RN]

You need to talk to occupational health and preferrably also to somebody from infectious disease.

They will be able to answer your questions regarding the statistical risk and your individual risk and outline what other things you need to know.

I worked in acute dialysis and people can have all kind of infections, sometimes they are HIV positive. Exposures happen sometimes despite being careful, for example blood splash or getting stuck when pulling out the dialysis needle. We can't give you medical advice here but generally speaking I think that while it is scary to get stuck knowing the patient is HIV positive, it is still the better scenario that you describe because the virus load is very low or not detectable per patient and you got post exposure prophylaxis.

[Horseshoe, BSN, RN]

I agree that your risk is pretty low. But for your husband's sake, I'd practice safe sex until you test negative at the appropriate interval. Definitely seek the knowledge and advise from your employee health department.

Good luck, but I think you will come out of this okay. Try not to worry too much, though it's perfectly normal to be aware of it and a little bit shaken at this point. Take care.