A few people have asked about the details of my needle stick in hopes of preventing a similar accident for themselves. The stick resulted from a surgeon who failed to follow safety protocol several times on the day I worked with him. A few minutes before I got stuck the scrub nurse reprimanded him ("I could have stuck myself!") for leaving a needle on the sterile field without telling her it was "down."
When I got stuck, my hands were on the sterile field where we are typically instructed to keep our hands to avoid contaminating ourselves when not actively assisting with the surgery. The attending* placed the needle (in a holder) directly into the back of my resting hand. Oops. After removing the needle, he made brief eye contact then went on working. Never said a word about it. When I saw blood pooling under my glove a few minutes later I knew the needle had penetrated my glove & skin.
That said, most needle sticks in the OR are self-inflicted. Surgeons stick themselves relatively often. My classmate stuck herself 2 days after my stick trying to remove a needle from suture. She'd never done it before and her hand slipped. The surgeon (a different one) told her that if he were in her position he would not go to the ED to follow up. Despite an inherently low risk of HIV transmission via solid needle and the patient's lack of risk factors for the big 3 bloodborne diseases, my classmate opted to visit the ED to gain some peace of mind.
I now know that an ED visit is required (at least at this particular hospital) if you want postexposure labs drawn on the patient to determine infectious disease status. It's important that students feel free to break scrub immediately to go to the ED.
Needle stick aside, the aftermath was marked by poor communication and unnecessary confusion about how to proceed. HCV transmission risk (unlike that of HBV) is fairly low, but I'd like to see future needle stick accidents handled more expeditiously. I've certainly learned (as well as been told by several more advanced colleagues) that not everyone will have my best interests at heart and that I may be solely responsible for my own safety & well being.
*Not affiliated with my school. I'm pretty sure any surgeon affiliated with my school would have both followed protocol and apologized for an obviously accidental but still unfortunate needle stick.
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4 comments:
My first stick was on the last call shift of my senior year; I was left alone to sew up a stellate scalp lac and during clean up I stuck myself on a needle that I had put on the field early in the repair without locking it. I'm not totally sure it was even used, but it was certainly scary. If it makes you feel better, the transmission rates are incredibly low for solid needle sticks and a vast majority of surgical residents will have stuck themselves by the end of their residency, yet most still have livers. I can relate to the feeling, though, and that's terrible that the surgeon made no comment. Scary to realize how on our own we can be.
You're lucky.
My first stick was in July 1981, thanks to an overbearing S.O.B.-of-a resident who made me, a new intern, nervous and jittery.
The patient was a woman with repeated opportunistic infections, who was later proven to have one of the first cases of heterosexually transmitted AIDS from her unknown-to-her bisexual husband.
In those days, we really didn't know what we were dealing with, and there was no testing.
I suffered in quiet misery with "not knowing if I was going to get that weird disease" for several years.
MedInformatics:
My, now that you put it that way I feel very lucky indeed. It comforts me to know I can detect a developing HCV infection with blood tests. I'd rather know definitively, even if the news is unpleasant, than endure the quiet misery of not knowing.
My first round of PCR testing came back negative. I'm glad you weren't infected with HIV and my heart goes out to those who aren't so lucky.
My needle stick was due to an orthopod who failed to numb the periosteum properly. Patient bucked... 18 ga needle straight into my thumb. Worst moment of my life.
Most important thing you can learn from this is that no matter who you're working with, safety comes first. Your future health and happiness should ALWAYS come first...
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