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Overpowering terror!! HELP PLEASE
Feb 28, 2010

cHello Dr.Bob, I believe you have on many an ocassion helped people return to sanity.It's my turn now Dear Sir.I am a junior resident in department of general surgery here in India.I was instructed by my professor to carry out fine needle aspiration cytology under ultrasound guidance from a soft tissue lesion in the lateral aspect of neck.Having struggled, what with the transducer in one hand and the syringe in the other, I had managed to aspirate a teeny amount.While attempting to smear, a droplet(probably from the base of the syringe..a single teeny-weeny droplet) likely got into my eye.The patient's HIV status is UNKNOUN.I walked immideately across to my Prof's chamber, and reported the incident, inturn I was asked to a report to a specialist in the department of community medicine. After giving me a patient hearing, he deduced, that since the quantity was "A single, teeny-weeny droplet" and that patient's HIV status was unknoun, PEP was not waranted.Dear Sir, I would ask your kindself to evaluate this situation.Was the community med. specialist right in advising against PEP?, I have not been able to focus on anything since the incident, am definitely very disturbed.Please write back

Response from Dr. Frascino

Hello,

Yes, I would agree with the decision to forego PEP. Although, I would also have recommended that the source patent be asked if he would consent to a rapid HIV test. You would have a result regarding the source patient's serostatus within 20 minutes. This information could influence the PEP decision as well.

As with other potential occupational exposures, you should get an HIV-antibody test immediately (baseline) and again at the three- and six-month marks. The odds remain astronomically in your favor that you did not contract HIV from this incident.

Good luck.

Dr. Bob



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