Squirted in the eye with peg contents

suzanne4, RN · Aug 4, 2007

It needs to be reported and you should have seen Employee Health at the facility immediately. The GI tract has normal flora that causes infection and severe when it gets into other parts of the body.

Example: E. Coli found in stool and normally in the gut, but can be deadly if it gets into the bloodstream.

Did you actually flush your eye immediately? And remember that if it was not reported at that time, how can you go back and say that it happened when it was not documented in the first place. You would have a hard time trying to get it covered by the facility. And if it was not documented, then they are not responsible.

But the other issue that you have is why were you not wearing goggles or a mask? If they provide it for you, and you were not using it, then you do not have any claim if something happens to you. Actually, you were in violation of OSHA for not having on the protective covering in the first place. If you do not wear it, then the fault is yours. If you got splashed around the goggles or shield, then that is another story.

In the future, always make sure that every exposure is documented, and do not leave it up to your supervisor on the unit to make that determination for you.

meownsmile, BSN, RN · Aug 4, 2007

No, not paranoid at all. OSHA dictates what is considered an exposure and last time i knew any time you are exposed to blood or BODY FLUIDS like that it is reportable and should be. Your supervisor is completely wrong, she just didnt want to take the time to do the paperwork involved. You need to report it yourself, hopefully it hasnt been more than 48 hours. And yes,, you probly should wear a PPE face mask when working with a peg or any other tube. I know we dont normally, but you have learned the hard way it can and does happen. And your personal experience should make you more cautious next time. I would want the face mask next time for sure. Maybe we can learn from you.

allantiques4me · Aug 4, 2007

You should have filled out an incident report.I hope you flushed your eyes thoughly!Yes you can catch an infection!

EmmaG, RN · Aug 4, 2007

It was soooooo nasty. I feel like I should wear goggles and a face mask now everytime I work with a peg tube. I just keep hearing my micro teacher talk about the bacteria that line internal tubing, all those little critters in my eye. The patient didn't have anything that we know of that should cause concern, but I still think it should be reported. Suppose I got some kind of infection in my eye or blood stream, that would qualify as a work related injury right? My supervisor didn't think so, and it wasn't reported. What do you think? Am I being paranoid?

Absolutely not; and your supervisor was dead wrong. Report any and every exposure.

If you are scheduled to work tonight or tomorrow, go in early, fill out a report and file it. If you're not working, contact your employee health nurse and go in to fill it out.

Protect yourself--- not just with PPE, but by reporting every exposure or injury.

MelodyRNurse · Aug 4, 2007

Yes, of course I flushed my eye out. And no my facility does not provide eye wear or PPE for staff working with patients who are not on contact or other precautions, nor have I even seen anyone use it or say it should be used in any other facility I've been in (to work with a peg). Should it be?? Anyway, thanks for you responses I will review the policy and attempt to report the incident, the sup. was there when it happened so it I should be okay. Thanks for your responses.

Suzanne 4- If facility does not provide the equipment. How did I violate OSHA? If I violated OSHA, so has everyone else I've ever seen work with a peg. As I stated earlier the patient was not on any special precautions, besides standard, of course.

By the way, the intestine is were E. coli normally live, I believe the stomach is too acidic for them to survive, but I understand what you were getting at.

ICRN2008, BSN, RN · Aug 5, 2007

If the facility is indeed not providing you with the proper PPE, then they are in violation of OSHA. However, it is your responsibility to bring this to your supervisor or infection control practitioner's attention, preferably before another exposure happens.

P.S. I have my own pair of goggles in my locker for just such an occasion. Masks are usually fairly easy to come by.

kcalohagirl · Aug 5, 2007

Ewwwwwwwwwwwwwwwwwwww. Your supervisor was dead wrong. It should have been reported. I'll keep my fingers crossed that everything turns out okay. Usually the stomach contents are acidic enough that you wouldn't have bacteria etc, however, the tube itself can be questionable. Kudos to you for thinking quickly and flushing your eyes out!

When I was in nursing school, my ICU rotation clinical instuctor used to laugh at me (not in an unkind way) because if something COULD happen with a Peg tube, it WOULD. to me. I swear, it was a bad case of murphy's law!

To this day, I have learned the value of a good pare of hemostats.

For example: stop the feeding, clamp a set of hemostats. unhook the tubing, attach your flush. unclamp the hemostats, flush. clamp the hemostats, hook up the feeding, unclamp the hemostats and start the feeding.

Most of the time even if you don't clamp stuff off, nothing will shoot back at you. However, it only really takes that one time.

marjoriemac, LPN · Aug 5, 2007

I once got sprayed with PEG contents because the woman whose PEG I was working on was demented and struggling and had a nasty habit of coughing before you could attach the syringe. Unfortunately it was not the clamping type tube which i prefer.

CapeCodMermaid, RN · Aug 5, 2007

You should report ANY kind of injury or exposure at work. I filled out an incident report one day because I got a puncture wound from a staple on one of the many packets of forms we used. Did they laugh at me? Sure...but suppose it got infected? The problem was the staples they bought were cheap. All employee incidents are discussed at Safety Committee Meeting...ended up by them buying better staples. I know this was minor, but the point is...report it.

I worked briefly in home care and one day I fell in a patient's yard. I didn't think I hurt myself, but I called the supervisor and filled out a report. I'm glad I did. The next day I could hardly move my arm. I had injured it and ended up having to work light duty and get PT. I had a partial rotator cuff tear. If I had brushed the incident off as minor, all the medical bills would have been my responsibility. The point is...report it.

We have emergency eye wash stations in our clean utility rooms. I've only been at the facility for a month and have already found 2 problems. The rooms are locked so if you did splash something in your eye, especially if you were in pain, how long would it take to find your key. And secondly, the eye wash units themselves look prehistoric....water from the tap! My eye doc tells me if I ever need to wash my eyes out, I'd be better off using normal saline.

And, if I were you, I would speak to the infection control nurse or central supply or whoever does your ordering and order some goggles. The OSHA rules are pretty clear on what an employer much provide for PPE.

RunnerRN, BSN, RN · Aug 5, 2007

Ewww....you should have been down in the ER getting a Morgan lens and 1-2 liters of NS run through your eye. Even though E. coli may live in the intestines, would you really want to take the chance? This is obviously a chronic sick person who could have really interesting friends growing in her body, even if they weren't picked up on a micro screen.

Report!

pirap · Aug 5, 2007

Chances are your hospital DOES have the PPE but they just don't have them on the floor/your manager doesn't keep them on the floor. I went to a phlebotomy class a few weeks ago and I learned of these "neat" things that we were supposed to be using to transfer blood draws to the test tubes--can't think of the name of that device. Anyway all along I had been pulling blood out a PICC into my syringe and just attaching an 18 gauge and squirting it into the tube---I NEVER REALIZED THAT WAS WRONG AND THAT WE WERE SUPPOSED TO USE THAT SAFETY DEVICE!!!!! Our manager knew of this and NEVER had these items stocked...and come to find out I could have been FIRED for not using them AND if I would have been exposed to something DEADLY they would have NOT covered my long term treatment!!! I was so mad!!! At our hospital we can order those from central supply and charge them to the patient..you really need to look into what happened--if you can recieve them for a patient on contact/bodily fluid isolation you can order PPE for your protection on ANY patient!