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Possible health care worker exposure/ symptoms

Aug 5, 2007

I am a RN in the ER. I am also 5 months pregnant. I was treating a patient that is a known drug abuser butit is not known if she has HIV. I was wearing gloves when the HUB to her IV became unattached. As I pealed away the tegaderm bandage a small amount of blood sprayed out. I did not feel any go into my nose, mouth or eyes, but I don't know, just didn't feel anything. I took care of the patient and then left. After I took off my gloves and a little later I noticed a small amount of blood on my hand on intact skin, I washed it off. A little later I looked down and saw a drop of blood had landed on my stethoscope earpiece, I don't know if it had been in my ear or not, it was a small drop but still moist as I easily wiped it off with a paper towel then went back to work. I don't know if there was any open cuts in my ears or anything. I then started thinking about it 2 days later and got scared. Could I have gotten HIV this way? Are ears a mucous membrane that could have transmitted this. I did not notice any other droplets anywhere, my shirt did not have any nor did my face. I am 5 months pregnant and scared. Now 20 days after the incident I am having diarrhea for 3 days now. I also have a rash the size of a dime on my chest that is red and itchy, but that is it. No fever so far or swollen glands. I am extremely tired but I am pregnant so I don't know what that is from. Does a small dime size itchy red spot sound like the ARS rash? What about the diarrhea? Is that characteristic of ARS? Please don't tell me to go to mmy supervisor because I already passed the PEP window and I am pregnant anyways and really just want to know if this is even something to worry about to go and talk to anyone. It was a small amount of blood on my hand and earpiece, could that be a high risk exposure. You will really be helping a nervous and pregnant lady. I was tested for HIV 3 months ago at the beginning of my pregnancy and have only been with my husband of 9 years. Thank you so much

Response from Dr. Frascino


The ear canals are not mucous membranes.

From what you describe, you did not have a significant occupational exposure. However, I recommend all potential exposures to HIV or other bloodborne pathogens be reported on an incident report so that they are documented. A more formal evaluation can then be done quickly and, if needed, a treatment and/or testing protocol begun.

Your "symptoms" are not suggestive of or worrisome for HIV ARS.

As for going to your supervisor, the point I want to stress is that if you had gone to your supervisor at the time of the incident, you would not be in your present conundrum! Occupational-exposure policy and procedures are in place to help you! I encourage you and all HCWs to use them!

Dr. Bob

Funny! Just wanted to share it

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