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Possible vomit in eye
Nov 4, 2009

Dear Dr. Bob, I am a nursing student. I have developed an intense fear of both contracting and trasmitting bloodborne pathogens. I have read your archives and current posts extensively, and so I do feel my knowledge has increased considerably. Since I know many of my fears are irrational or focusing on the most nonexistent odds, I have been focusing on not playing into these fears and not allowing myself to freak out about things that are not a risk.

Today I was caring for a pediatric pt w/ H1N1 on contact and droplet isolation. He threw up into an emesis basin, and I took it into the bathroom, rinsed it, and dried it out.

When I was leaving the room and was removing the mask, gown, and gloves I had on, I reached up to remove the mask, and the tip of my finger touched the bottom lid of my eye. Now, of course, I was plagued with an internal struggle between freaking out about this or realizing that 1. wouldn't I have known if there were even visible fluid on my finger?, 2. HIV is not transmitted through vomit, and 3. even if it were, it would have been at least a few minutes between him throwing up and me *possibly* touching my eye or bottom eyelid.

I read your archives again as soon as I returned home and that confirmed that HIV is not transmitted in vomitus - a risk only exists if there is visible blood present. Looking back, I'm relatively certain I removed my gloves before removing my mask, which would make it a nonexistent risk.

I am really trying to have a reasonable perspective on this since I know I have developed a phobia -- was I right in recognizing this as not a possibility for exposure? I know you always say we should report possibly occupational exposures, but I feel that every time I fear about something, I'd be going weekly if not more, and I know that is most likely irrational.

Please help me.

-Recovering-Phobic Nursing Student

Response from Dr. Frascino

Hello Recovering-Phobic Nursing Student,

Your reasoning and assumptions are correct. Your HIV-acquisition risk is nonexistent.

Having "an intense fear of contracting and transmitting blood-borne pathogens" is going to be an ongoing challenge for you should you continue in your present career path. You really have two options:

1. Choose another career.

2. Get counseling (psychotherapy) to help you confront and conquer your totally unwarranted and completely irrational HIV fears.

Good luck!

Dr. Bob



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