Published Dec 2, 2003
Your're it now - perhaps.
On your last exposure, were you tested for everthing? Even prion disease which will incubate for up to 40 years? How about Hepatitis C? Average time from exposure to onset of symptoms is 20 years. Most West Nile Carriers are asymptomatic, but could transmit to you with a blood-borne path exposure. A report just came out that tetanus is on the rise with parental drug users.
Let's face it. HBV, HCV and HIV aren't the only BBP. There are too many BBP to count and many do not show up for years.
Zero tolerance for sharps exposures and we need to up the post-exposure care and testing. We are putting our families at risk if we don't.
You raise some very valid points in your post. the last exposure I had and we are going back many years, i was only tested for Hep B and HIV as was the patient.
I do agree with the rise in the number of BBP that the testing required for post exposure should definitely be upped to protect not only the health care provider but their families and others that they come in contact with as well.
when i had a finger stick last year, it occured while cleaning instruments(in m.d. office), the doctor i worked for did a complete Hep panel. i think because we couldn't say what instrument was used for who. it wasn't part of protocol to have it done- my manager even asked why the doctor ordered the testing(because of the cost). that is what most facilities have a prblem with-the cost!! that will always be there concern:o
You bring up an interesting topic. I (Thank God) have never had a needlestick (crossing fingers, knocking wood, etc.)but I ma not familiar with my facility policy which I probably should be. I mean I know we have a policy and if you recieve needlestick you report to ER and recieve blood tests, I also beleive if it is high risk Pt they also start the HIV pre-meds, I am not certain though how extensive the testiing is regards multiple long term BBPs but of course if we are going to walk around worrying about everything we may get that would just be too depressing.
Yes, definitely cost is a big factor in just much testing is done. But I also agree with CCU, we can not run around and worry about every creepy crawly germ that is out there. Just follow policy and procedures, and universal precautions to minimize exposure. But sometimes accidents will happen no matter how careful we are.
Thanks colleagues! I am so glad to see realistic concern.
On the cost: The procedure to test baseline for the minimal three diseases at time of injury and to one year is a mandatory federal law, as well as offering the post-exposure cocktail. So there is no decision to be made - it has to be done.
While we cannot worry about every little thing (Hey- I drive on the interstate!) disease transmission knowledge is so important. We can
1..prevent disease progression,
2..treat the disease and
3..very importantly, keep from spreading it.
I know a nurse who spread HepC to her children and even grandchildren (childbirth and sharing razors) before she had symptoms and a test for HCV was available. I think she suffers more now from guilt than the disease.
What if the disease was to incapacitate the nurse? How could it be proven that he/she got it from a needlestick injury unless testing was done? So many of the diseases take decades to manifest.
Just from the reported injuries and the minimal testing done, more than 300 nurses die each year. That is more than a jumbo jet! Imagine what the FAA would do if a jumbo jet a year kept crashing from the same cause?!?!?!
Safety sharps are a good effort, but not the whole thing. And we need to make sure that the specific safety sharp isn't just a sharp with the word "safety" printed on the package. Some supposedly safety sharps are actually responsible for INCREASED injuries! My favorite (NOT!) is the one where you slide your finger up a dirty needle!
Hey manufacturers (especially that one in NJ) Nurses are not one-a-day disposable items!
Colleagues: I love you all so STAY SAFE!
Thank you for your post! It is always good to be reminded of the potentials in our line of work. I hope to carry this with me and remember to s-l-o-w d-o-w-n for that extra minute or two when dealing with any kind of sharps etc.
Keep up the good work!!
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