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Possible exposure during surgery
Apr 13, 2010

Hi Dr Bob,

I asked this question a few weeks back. I didn't get a response, but I'll give it another try. I'm a third year medical student, and in February I was doing a rotation in general surgery. We had to do a laparascopic cholecystectomy on an HIV/Hep C positive patient. I forgot to wear those surgical shoe covers for the surgery. When the surgeon put a drain in the abdomen, some blood came out from the other end and landed near my feet. There was a little puddle of blood near my feet, but I don't think any blood fell directly on my shoes. I'm worried about the potential of blood spattering on my shoes and soaking through. I've been obsessing over this for the past month and a half, and I'm wondering if this is an exposure or not. I'm guessing not, but I'll leave it to you to advise me. I'm probably not going to get myself tested for this (as I'm sure I shouldn't), but I still can't get it out of my head.

Thanks for taking the time to answer this question. I know how busy you must be. Take care,

Michael.

Response from Dr. Frascino

Hi Michael,

Your HIV-acquisition risk from this potential occupational exposure is completely nonexistent. Your instincts and assumptions were correct. Testing is not warranted. Being a third-year medical student and suddenly being confronted with real patients, real blood and real life (and death) can be challenging, disorienting and even at times frightening. Rest assured we all had similar experiences. When I was in medical school and we would learn about or evaluate a patient with a serious or somewhat bizarre illness, at least several of my medical school buddies would wonder or worry if maybe they too had the illness! A healthy respect for various diseases, both communicable and noncommunicable, is appropriate. Irrational fear, however, is not. Knowledge is the best weapon against unwarranted worry. Spend some time perusing the information in the archives of this forum related to exactly how HIV is and is not transmitted non-sexually. It should help to further quell any residual worries. And just for future reference, I recommend that any and all potential occupational exposures be reported and documented. All health facilities and medical training programs have policies and procedures in place for documenting, evaluating and managing occupational exposures. Had you reported yours, the occupational medicine team (or physician in charge) would have immediately reassured you there was absolutely no risk for HIV/hepatitis C transmission whatsoever.

Be well. Stay well.

Dr. Bob



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