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HIV+ Baby's Blood Spilled on my Arms!
Oct 12, 2007

Dr. Bob:

I am a pre-med student with an HIV question I am unsure of, and I actually teach HIV Prevention at my college's campus.

Here goes:

I was volunteering for a doctor I've been shadowing for 5 years. She asked me to hold a baby for a (may I say hot as hell young) nurse who was setting up an IV on the baby's leg since its arms' veins were too miniscule to accurately draw from.

Anyway, I was not wearing gloves, and somehow the butterfly needle came off the plastic pre-setup, and within a few seconds, my arms and hands were drenched in this baby's blood, and some droplets splashed onto my face, and to my horror, even my eyes. I stormed out of the room, overtly furious at the nurse, and saw the doctor I shadow get nervous quickly when she saw me covered in blood.

It turns out, the baby was HIV positive (the poor thing's mother is a local 17 yo Af-Am crack-whore).

The doctor had me wash and scrub down with betadine twice, and then finally with soap a third time. She then inspected me for cuts and found none. Although, we did notice I had a large not-yet-healed sore from a picked hangnail on one finger. Hence, my worries!

The Doc said she felt a PEP was not necessary, nor was a rapid response antibody test. This was 2 months ago. I'm nervous as hell anyway.

Do you think I'm at risk, and if so, which test should I get in a month (assuming you'd recommend the 3 month mark)?

I've also been a good pre-med nerd and read into the HIV parts of Harrison's Internal Med and a good dozen PubMed articles on transmission, and my own answer would be NO. But you're the boss of this domain, in my mind!

Thanks, Worried in SoBe.

PS: on the plus side, that hot nurse felt bad for me, and accepted when I told her she could make it up to me by treating me to coffee. She's now my girlfriend. I'm still worried about the baby's blood though. Thanks!

Response from Dr. Frascino

Hi To-Be Pre-Med Stud. (short for student),

I agree PEP was probably not necessary based on the information you provided; however, follow-up HIV testing is, if for no other reason than your having had an exposure and being "nervous as hell." I should point out there are other reasons as well, including getting some HIV-infected blood in your eyes, the amount of blood you were exposed to and your non-intact skin around your hangnail. My advice would be to get a rapid test at the three-month mark. If negative, repeat the test at six months.

Overall the risk of your seroconverting due to this "occupational" exposure is extremely minimal. However, I still believe testing is warranted. It's also the most effective and efficient way for you to put any residual worries permanently to rest.

As for the hot nurse becoming the pre-med stud's main squeeze after a screw-up involving blood, babies and 17-year-old crack-whores, didn't I see something like that on Grey's Anatomy a few seasons ago?

Good luck! (with your HIV test, your medical career and, of course, Nurse Goodbody).

Dr. Bob



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