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Splash in the eye, risk?
Nov 20, 2006

am a dental student working in a community clinic, today I performed a scaling and root planning on a HIV+ patient; during the procedure I was not aware of her HIV status (stupid me not to check!). When I was scaling, a lot of blood was all over the gingiva, and so I sprayed the the water+ air into her mouth while suctioning with high speed. Somehow spashes of "fluid" bounces out and some hit near or maybe into eye and some probably hit my eyelash (I remember I blinked to avoid the water...and I don't know how the heck the water got thru my loupe...

I did not feel anything go into my eye and I just kept working.

After the patient left, when I was writing my tx note and I found out her HIV+ status and I became a little freak out.

logically, I don't think I need to be concerned because

1. I am not sure it even went into my eye. 2. I am quite certain that the fluid that hit my eye region are not totally blood, actually mostly should be the water from the water spray ( i think the high viscosity and density of blood would not bounce that far to my face, my face was pretty far from her....it would first be suctioned from my high speed vacuum. But again, some of the water might have some virus in it since it contacted the person's blood. 3. If the fluid went into my eye, i didn't even feel it, I was certain that it didn't go into my eye, i just feel the splash to my face. it must be in very very low concentration.

I decided not to go thru the PEP regiment since I called the HIV hotline and the person blieve that I should be in minimal risk, but I am just very concerned.

Do you think what my risk are, and how concerned should I be? am I stupid not to proceed with PEP?

Response from Dr. Frascino

Hello,

Your HIV risk sounds negligible to nonexistent. PEP is not warranted.

The thing that concerns me most is that you only became concerned when you were writing your note and noticed the patient was HIV+. No, it was not stupid of you not to check! However, it is completely wrong of you to worry, only because you subsequently found out the patient was HIV positive! Universal precautions are universal for all, not only for patients who you know are HIV positive!!! Please note that here in the U.S. 25% of the one million folks estimated to be HIV positive do not know they are infected by the virus! This is a lesson you must learn immediately. Treat all your patients as if they could have a blood-borne infection (HIV, hepatitis, etc.) Universal precautions are universal for a good reason! Stay safe. Stay well.

Dr. Bob



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