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Needle Stick Student Update
Sep 25, 2007

Hi Doctor Bob, I am the student who was stuck with the needle. You and the ER physician were correct in my lack of need for PEP. We tested the source pt the day after the stick and it was negative for HIV, hepC, and HBV.

Response from Dr. Frascino

Hi,

Glad to hear the source patient was negative. However, it's important to note that even if he/she tested HIV positive, I still would not have recommended PEP for the type of potential exposure you described.

Dr. Bob

Stick with suture needle? Proper managment by ER doc? Sep 24, 2007

Hi doctor Bob, I am a medical student who was stuck with a suture needle about 16 hours ago. I was wearing double gloves and they were covered with pt blood. I did not see any signs of a wound on my finger, nor did it bleed. The source pt's status is unknown. I proceeded to scrub out and wash my hands and used betadine to clean. Again, no sign of a puncture wound, but I definately felt a prick sensation. The ER doctor examined me and after I told him my situation, he decided against using PEP. Today, we are going to attempt to get the source pt to give consent for an HIV test. Considering what I have told you, do you think the ER attending was correct in his management to not administer PEP? I really would appreciate your response.

Response from Dr. Frascino

Hello Stuck Student,

I agree with the ER doctor's decision. Suture needles are solid and small gauged. You were wearing two sets of gloves. There was no visible puncture wound. The patient's HIV status is unknown. Taken together, this information would not constitute an HIV-transmission risk that would warrant PEP. Documenting the potential exposure and getting screened for bloodborne pathogens per your institution's policy and procedures for possible occupational exposure is all that's recommended.

Dr. Bob



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