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terrified of possible exposure, breastfeeding
Aug 6, 2002

DR. FRASCINO, I WORK IN A HOSPITAL AS AN RN & I AM WORRIED ABOUT A POSSIBLE EXPOSURE. I WAS DOING A ROUTINE ASSESSMENT ON A POSTPARTUM PATIENT WHEN I TOUCHED A "CHUX PAD" THAT HAD VISIBLE BLOOD ON IT W/OUT GLOVES. I WEAR GLOVES ALL THE TIME BUT HAD TAKEN THEM OFF TO USE MY STETHOSCOPE NEVER THINKING THAT I COULD HAVE AN EXPOSURE OF THIS KIND. THE ISSUE THAT CONCERNS ME MOST IS THAT I HAVE VERY DRY CRACKED HANDS FROM THE HOSPITAL SOAP. I DO NOT REMEMBER SEEING ANY CRACKED,OPEN BLEEDING AREAS ON THAT HAND BUT I WAS FREAKED OUT AND WASHED MY HANDS QUICKLY. I DO NOT KNOW HER HIV STATUS AS SHE HAD NO PRENATAL RECORD ON THE CHART THE DAY I CARED FOR HER. THIS INCIDENT OCCURED A COUPLE OF MONTHS AGO AND I NO LONGER HAVE ACCESS TO HER RECORDS. IS THIS A POSSIBLE EXPOSURE SITUATION. ALSO, WHAT IS THE RISK OF TRANSMISSION IF BLOOD SPLATTERS ON YOUR LIPS OR IN YOUR EYES. I AM WORRIED BECAUSE THESE TYPES OF THINGS HAPPEN OCCASIONALLY. I AM BREASTFEEDING A BABY PRESENTLY AND AM SCARED I MAY HAVE GIVEN HIM SOMETHING. HE HAS BEEN RUNNING A HIGH FEVER FOR SEVERAL DAYS, WENT TO THE DR. & HE SAID IT WAS VIRAL (LOW WBC'S), BUT THEN HE DEVELOPED A RASH AFTER FEVER BROKE. PLEASE RESPOND. I AM VERY SCARED ABOUT THE HEALTH OF MY CHILD MORE THAN ANYTHING. I HAVE AN APPT. WITH MY DR. TO HAVE AN HIV TEST NEXT WEEK BUT THE WORRYING IS DRIVING ME CRAZY AND I CANNOT STOP THINKING ABOUT THIS. THANK YOU SO MUCH FOR YOUR TIME, EXPERTISE, AND WILLINGNESS TO HELP PEOPLE. YOU AND EVERYONE ELSE THAT RESPONDS TO QUESTIONS ARE TRULY PROVIDING A GREAT SERVICE!

Response from Dr. Frascino

Hello RN,

Touching a "chux pad" would be considered extremely low risk. Even though you have dry cracked hands from the hospital soap, you did not have an open bleeding wound, so this risk is minimal. Blood splattering to lips or eyes would be considered a mucous membrane exposure. This carries a very small, but not non-existent risk. Since you work in a hospital, your possible exposures should be reported to your occupational health division. Every hospital has a protocol in place to evaluate possible exposures and offer post-exposure prophylaxis medication if indicated. The incident report forms are confidential. You and your co-workers should familiarize yourselves with the policy and procedures concerning potential occupational exposure to blood-borne pathogens - HIV, hepatitis C, etc. Do I think you are HIV-infected? No, I strongly doubt it. Your baby sounds like he/she has a very typical infant viral syndrome, which often consists of fever followed by a viral exanthem (rash). Try not to worry. I'm quite confident things will turn out well for you. But do review your hospital's procedures related to possible exposures. It could be critical to you and your co-workers in the future.

Good luck. Stay well.

Dr. Bob


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