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Worried resident...again
Jun 2, 2009

Hi Dr. Bob, I am the medical resident who wrote you previously about an incident that had happened where I brushed my arm against a sharps container. Believe it or not, the same incident has happened to me again, and I would really appreciate your input again. I was in clinic the other day, sitting on a chair, and I rolled backwards and hit my head on the container. It was pretty sharp, and I hit my head pretty hard. I looked back at the container and did not see any protruding needles. The corners of these containers are pretty sharp, but obviously the thought that has entered my mind is that I may have hit a needle sticking out of the box, and hit it back into the box. There are occasionally needles that do not get placed properly in the box since they are placed horizontally and will often not get pushed into the box properly. The reassuring part is that the room had not been used for 3 days prior to this incident. Most of the needles in the box were fine PPD needles, while few were larger bore needles, and I know that a person may not necessarily feel getting pricked with a fine needle. Right after the incident, I went to the secretary and she told me that she did see a drop of blood on my scalp with surrounding redness. I washed my head when I got home and when my wife looked at my scalp later that night, she did not see any wound. What worries me is getting hit in the head by something sharp, the blood after the wound and although I did not see a needle, I may have pushed it back into the box. To be honest, Im unsure if I felt a prick or not, but I likely would have felt it. I am so tired of these incidences. They seem to keep happening to me and then I have to wait 6 months for total reassurance, but this is happening to me way too often. I spoke to occupational health, but I do not think that they are taking me seriously because I have had a few instances where I felt there may be a risk. What do you think about this incident. They are hesitant to test me. I know all about the CDC guidelines, but what about potential needlestick exposures. I am just so sick of waiting 6 months, and I would love to take a 3 month test and be completely reassured. What do you think in terms of sexual relations. We are currently using condoms given my concerns, but it has definitely affected my sex life. I have seen a psychiatrist, but I would like to know what an HIV specialist thinks about my issues to be able to put it all into perspective. Thanks again so much for your help. You are always dependable, and I will donate again to your charity for all your help.

Response from Dr. Frascino

Hello,

Once again your HIV risk is essentially nonexistent. Sharps containers are designed to keep the used sharps away from clumsy residents and other health care workers! If it were a significant HIV risk just to bump into them, they really wouldn't be of much use, now would they?

I think occupational health may be correct in assuming you are becoming irrationally fearful of HIV infection. I would suggest you consider getting some professional help (psychotherapy counseling) to help you confront and conquer these irrational and unwarranted fears surrounding HIV. This is a fairly common phobia for health care workers. The anxiety produced by these unwarranted worries can become an impediment to your career. Dealing with this problem now could help avoid a more significant problem later.

Thanks for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated.

Be well. Stay well.

Dr. Bob



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