Needlestick
Posted by GruntDoc on May 28th, 2005
Tonight I got one of the built-in hazards of medicine: a needlestick injury with a ‘dirty’ needle.
I was going to, well, touch-up the anesthesia on a digital block that wasn’t quite right, and as I picked up the syringe I got distracted. The next thing I knew a 27 gauge needle went right into a finger. My finger. My ungloved finger.
The first thought that flew into my mind: "Crap! I’m better than that." Really, I was terrifically disappointed in myself, and angry I’d made the rookie mistake of not watching the needle in my hand. I handle needles for a living, and they never get me, they get the patient, as intended. That’s how it’s Supposed To Be.
My next thought was "This is the last needlestick of the rest of your life". I mentally reviewed the very very brief medical history I had taken of this patient, and decided more social history was in order. After a polite explanation I addressed some of the deficiencies: "Any drugs?", I inquired. "What kind of drugs?", replied my suddenly less-than-satisfying patient. "IV drugs" said I. "Oh, no, no IV drugs." The sexual history was mercifully brief and reassuring, and no transfusions, etc. Never had hepatitis, no other problems. Good.
As the patient had seen me stab myself (then mildly curse, appear peeved, and ask a lot of pointed questions), he knew what was up and was quite gracious about consenting for testing. Blood was drawn, and then I fixed his problem. I had to get back on the horse, and despite the melodrama preceeding I realized my risk was small.
His rapid HIV was negative, which I expected but wanted to see anyway. Of the other two major concerns, my hep B is covered (I’ve had the series, a booster, and am a responder) and I can’t do anything about hep C anyway, so I choose not to sweat that. I’ll check up on those, though, out of curiosity in a day or two.
Mortality sucks. Mortality through stupidity would be unforgivable, for me, and I resolve to not make any more stupid mistakes.
Right.
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May 28th, 2005 at 8:43 am
Glad everything turned out alright. That must be horrifying, really.
May 28th, 2005 at 9:20 am
GD,
I understand the sentiment of being very annoyed at yourself. However, you should be commended on your judicious choice of subjects with which to illustrate this. We’re wishing you all the best.
-j
May 28th, 2005 at 9:35 am
Needlestick
Alan, a.k.a. Gruntdoc, my favorite ER doc blogger, has an interesting post today regarding getting a needlestick injury…
May 28th, 2005 at 9:50 am
Almost certain that you will be OK — but I completely understand your self-directed anger. Accidents happen, and sometimes they happen to the best-prepared folks.
May 29th, 2005 at 1:22 am
links for 2005-05-29
RadioAltar debut concert and album release 6/4/05 7p Pleasanton Community Church in Pleasanton, CA (a gang from the ALCF band) (tags: christian rock concert) GruntDoc: Needlestick a fav ER medblogger has a needlestick and explains what goes on in our …
May 29th, 2005 at 4:35 pm
scary! ouch! scary! don’t do that! Glad everything is ok!
May 29th, 2005 at 6:17 pm
We are just now using the Rapid HIV test in the ED, and your story demonstrates how important they can be in cases like this – if for no reason other than reassurance of the “stickee.”
May 30th, 2005 at 10:19 am
makes me cringe. i’ve been through that several times., and no matter how stupid the unique moment, these things happen. i’m glad this sounds like a low risk stick. salud.
May 30th, 2005 at 8:03 pm
That sucks – glad everything turned out ok! I stuck myself with a dirty needle about a year ago trying to engage the safety mechanism (yeah, I know). The patient was low risk, 45 yo male c/o chest pain, but for some reason refused to do an HIV test. (I think he thought he could get AIDS or something from it.) That was not a fun six months of follow-up testing for me, especially since I learned that I hadn’t seroconverted from my initial Hep B series…