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Medical Intern with possible exposure
Aug 2, 2011

Dear Dr. Bob,

Thanks so much for such a great online resource. Two days, ago, I was doing IV morphine push (through a hiplok line)for one of my patients who is HIV +ve. During the procedure, the gloves were so tight (smaller than my size) and one of them got torn and fingers got in touch with the point of entry of the line(where you hook the syringe to give the push). There was no blood on the site and there was no cut on my fingers. Do I need to worry about that?

Please advise

Thanks once again,

New Intern

Response from Dr. Frascino

Hi.

I always feel a bit sorry for folks requiring hospitalization in July, as it's the month new interns are let loose on the wards. I'm not being critical of you. I've been in your shoes and it's really quite frightening to suddenly be "the doctor" instead of the medical student. But don't worry, it gets better. As as new intern you need to learn one very important lesson -- accidents do happen. That's how I became positively charged in 1991( I wasn't an Intern at the time but it was an accidental occupational exposure to HIV). If you have an occupational exposure or even potential occupational exposure, you should report it immediately to your occupational health division so that the incident can be documented, evaluated and, if necessary, treated. If you had had a significant HIV exposure (which you did not, by the way), time would be of the essence in starting post-exposure prophylaxis (PEP). PEP is most effective when begun as soon as possible after the exposure. If more than 72 hours have lapsed since the exposure, PEP would no longer be warranted.

Sorry for the long preamble, but I try to never miss an opportunity to remind health care workers what to do in case they have an occupational exposure.

Good luck New Intern, and welcome to the wild, wacky and wonderful world of medicine!

Dr. Bob



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