Aug 13, 2012
I am a dentist and suffered a needlestick injury on my lower arm by one of my scalers when treating a patient and I would like to ask a few questions if that's alright..
The injury was deep enough to draw blood. I followed procedure, cleaned and soaped, asked patient if any known bloodborne viruses and said all was clear. Also, agreed to bloodtesting if necessary. Due to workload I did not attend Accident and Emergency until next morning. I informed the staff at the hospital that the patient was high risk but could not confirm as information was not offered by patient. The dental practice contacted the patient but could not reach as patient left for vacation but the patient's mother assured us that the patient will return in a few days and is aware and willing to take the test. I know that the chances of contracting something is very low even if the patient is HIV+, HCV+. I am vaccinated against HBV and had blood test prior to starting to work which was two months ago -the results where kept by the company that I am working for but I did not receive a copy so I don't know the exact level of my antibodies, which again I told the staff. If they weren't enough I would not be able to start working but still I should know.. Anyway no testing was done to confirm nor did they ask to see the results. I asked my practice manager erlier in the morning but I am still waiting on them.
The doctor said that it was only a small wound. How can that be, since it bled? And the puncure point was obvious and slightly raised.. should I have a big gash across my arm. Is an injury from a needle any bigger?
Also, I want to ask is if it is the correct protocol to refuse anti-retrovirals to someone exposed on the grounds that the patient's high-risk status is unconfirmed and since patient is British that makes patient healthy until proven otherwise apparently. (I am not British, this does not reassure me in any way)
I was told that they would be taking a blood sample to keep for records and testing if necessary but would be disposed in a few months. What's more nurse AND doctor when I asked how will I know then if I have contracted something, said "If you become seriously ill in the next few months, jauntice and things like that we will do a test and will know." To be honest I almost started laughing. I thought it was a joke..
Now, apart form going to A and E, it is protocol to report the needlestick injury to the Occupational Health Department because they need to do follow up checks to make sure I haven't got infected as this would mean I would be terminated as a dentist. HIV+ dentists are banned from working in the UK so that they do not pose a risk to patients. Dump as it may be this is the law.. I am sure that the nurse and the doctor did not know that (otherwise they would not have answered so foolishly) so I told them that follow up was needed. Occupational Health contacted me while I was in the hospital and went through the same questions and told me the same things that drugs were not necessary but they would be doing follow up checks to make sure I am ok (God forbid I am not fired if I am positive- no, the public needs to be safe..).
Anyway, I am really disappointed as I feel nothing was done to protect me but they will be there to punish me if I actually get something.. I don't understand how the unkown status of the source equals healthy source and not a potentially dangerous.
Oh, forgot to mention, I was given a tetanus shot. Atleast not all my time was wasted.. Also, blood was taken for records.
I would appreciate if you could let me know if this sounds ok to you...
Thank you in advance
Response from Dr. Wohl
I agree that the response you received seems caviler. PEP should have been offered based on what you write. At this point you should get the HIV/HBV/HCV testing performed on the patient.
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