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Another nurse question..
Mar 20, 2008

Ok, I checked the forums...you have been helping people a long time-wow-what a great service you offer to the public!

I am an ICU nurse-recently cared for an aids pt (did not know this at the time), and I actually did not find out until 2 weeks later :-(, anyway..I started iv's on her-took me 3 pokes and finally got her iv on the last try-well as you prob. know a little but of blood almost always flows from the catheter hub while connecting the tubing..here's the problem...I always(NOT anymore) used to tear one finger of my glove off to be able to feel the vein on "hard to stick" pt's-I am about 99% positive that I didn't get any blood on me or my finger during this procedure but being it was over 2 weeks ago-I can't fully remember...I had dry skin with some "cuts" from the winter cold on my hands at the time(I think they were like 3 days old)-I called the health dept. at work and they didn't really want to do anything because they didn't think it was an exposure and it was 2 weeks later...what do you think-exposure? I am sure I am being silly..and I know I have prob. taken care of many pt's with hiv/aids-but hearing that diagnosis is scary, esp. since I was not being as careful as I should be...what do you think? Any suggestions?

Response from Dr. Frascino

Hi,

I would make only two brief points:

1. Your HIV-acquisition risk is essentially nonexistent. HIV cannot permeate intact skin even with your three-days-old healing "cuts" form the winter cold. I would agree with the assessment you received from the health department. Aside from documenting the incident, I see absolutely no cause for concern. If you want to take a rapid HIV test now and again at the three-month mark to calm any residual fears you may be harboring, fine. However, please note the only reason to test in this situation is for peace of mind.

2. If indeed you are "not being as careful as (you) should be," that is something you should change without delay! Remember, 25% of the over-1,000,000 HIV-positive Americans have absolutely no idea they are infected with the virus. Universal precautions are "universal" for exactly this reason!

Be well.

Dr. Bob



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