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Occupational Needle Stick
Jun 17, 2013

This has already been the worst week ever and it is only Wednesday. Sunday night while at work in the ICU I was administering insulin via a Novolog Flexpen to a patient. Following administration I unscrewed the flexpen needle and placed it in the sharps (or so I thought), I then returned to my cart and went to put away her flexpen (as these are reusable) when all of a sudden I felt a prick in the upper palm of my hand between the third and fourth finger, I looked down and low and behold the novolog needle had STUCK to my glove rather than dropping in sharps (I must have had tape glue or something there) and now it had poked my skin.

I immediately re-disposed of the needle, removed my gloves to find a small pin-prick of blood, and calmly walked out of the patient room, I informed my charge nurse and supervisor, washed my hands with soapy water and went straight down to the ER. While down in the ER the doctor and I washed my hands again to be sure, my blood was drawn for baselines, bloods were drawn on my patient, and I was started on PEP for HIV.

Yesterday I was informed that the patient's initial HIV test is negative but they are running a viral load test to try and rule out the patient being within the month window period. I was also informed that the patient tested positive for Hepatitis B antibodies, and had a reactive Hepatitis C result. The employee health office tried to keep me calm by telling me that even though my chances of Hepatitis C via needle stick are higher than that of HIV that the numbers are in my favor for a few reasons 1. I had gloves on, 2. The needle was so small and fine (30g, 8mm length, 3. It was a sub-cutaneous injection which means it was less likely to have hit a vein or artery, 4. I washed immediately, and 5. The patient wasn't bleeding at the injection site but I still feel doomed. They are waiting on the results of the patient PCR to see how much of the Hepatitis C virus was present in the blood and they did inform me that on average only 1.8% of needle sticks seroconvert, that the highest they've ever seen is 10% but that the larger percentage usually comes from large bore needles, deep penetrating wounds, etc. but I still cannot get myself to calm down.

Any words of wisdom? How concerned do I need to be? They told me not to panic, but I already am!

Response from Mr. Glenn

Thanks for your question,

I'm sorry to hear about your situation, but keep in mind that you're doing everything you need to do! On top of that experts have supplied you with some great information about your risk for all the things you mentioned. Most of those facts are in your favor! It really does sound like the risk of infection is remote.

Feeling worried is a normal reaction though. This situation is new and it just happened. But if you're looking for ways to help yourself calm down, here's a couple:

1) Find a trusted person to talk to that will listen to how you're feeling without trying to judge your risk (the experts have already done that!)

2) Wait. It's hard, but time heals the stress as you internalize the information that you've been given.

I hope all this helps! If you have any other questions, let us know. But in terms of the facts and figures of the situation, you've been well supplied!

Erik



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