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CSF exposure in nursing setting
May 17, 2012

Hi, I am a second semester nursing student and was observing a lumbar puncture on a HIV+ patient. It was going well until the resident was finishing the procedure, and he flung the needle around and splashed CSF fluid into the air. A small drop hit the lower outer portion of my lip. I had Chapstick on, which I immediately wiped off, then scrubbed my lips with soap and water, then treated them with hand sanitizer. I didn't have any cuts on my lips or mouth, and don't think that the CSF hit me anywhere else. The ER doctor didn't put me on prophylactics because he felt risk was very low and the liver damage I could get from the meds was a higher risk. Since then, I have been stressed and worried about my exposure, and am scheduled for all the follow up tests. What are my chances of getting HIV?

Response from Dr. Young

Hello,

Concern about occupational infection with HIV is real and having good information about risk can help improve one's willingness to provide care to people living with the virus. For this reason, I thank you for your posting your question.

Since you know that the index patient was HIV+, it would be extremely helpful to know if the person was on HIV medications and if their viral load (in plasma) was undetectable. If the patient was indeed undetectable, then the risk from this exposure was negligible.

Either way, since the exposure wasn't to mucous membranes, but really to your intact skin (lips), I'd think that you don't need to go on to post-exposure prophylaxis.

I hope that's helpful, BY



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