Needlestuck

Photo: AMagill

On April 13th I became blood brothers with a 56 year old alcoholic via a contaminated needle. The nurses were urgently trying to insert a new IV because he needed to be intubated. One of them dropped a 20 gauge angiocath with the safety chamber half closed onto some towels on the bed. I came along and picked up the towels, and was stuck in the left ringfinger right above my wedding ring. I looked and saw the needle sticking through a towel, and uncovered it to see an angiocath with blood in the chamber. I didn't bleed at first, however, so I almost felt like I was off the hook. Probably not really, but it didn't matter: I bled a drop, and then another. Not enough to do a blood sugar check! But enough. I would now be referred to, in lab and employee health records, as the Exposed.

The guy (the Source) was a hefty 300-pound fellow in full-blown delirium tremens—confused, angry, demanding to leave, too weak to get up, but strong enough to get a little combative. I had been wrestling him all day, trying to keep him in bed and out of leather restraints, which are not nice for him and not nice for the nurses (leathers require documented assessments every 15 minutes). I already felt well-acquainted with him. I didn't think we'd get this close.

The charge nurse said to let it bleed to wash out contaminants, and I went down to employee health. Had my blood drawn for a baseline HIV and hepatitis B and C screens—not to tell if I'm infected by this stick, but to verify I wasn't already infected if I happen to turn up positive later. His blood was also drawn for a rapid HIV screen and hepatitis. If he was reactive (a potential positive), I would go to the ER to initiate antiretroviral treatment, which can cause nausea, vomiting, and nuke your liver. Luckily he was negative, and blood cultures showed no growth.

Frustrating describes the whole situation. Since HIV and the various hepatitis virii can seroconvert up to six months after an initial exposure. This means that I have to go back in six weeks, three months, and six months for further testing. I have to do this even though he was negative because he might be pre-seroconversion. It also means I have six months to think about not exposing my kids in whatever way; and not exposing my wife, which has pretty significant ramifications for our sex life, to say the least. And everyone wants to know: who the f*&% the nurse was! Well, I know who it was. But I like working with her. She's a good nurse; but it was a fast and stressful situation and she was careless.

I think I'll be fine. HIV has a 0.3% infection rate after a needlestick; HBV has up to a 30% rate but only if you're not immunized (which I am). So we'll see.