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Risks of giving First Aid and CPR
Jun 11, 1999

hello dr. recently a friend(unknown if hiv positive) fell and cut a severe gash above his eye. I arrived on scene several hours later.He refused medical treatment and was in a severe drunken state. I offered him wet compresses to place against the gash(blood had allready dried). the wet paper towels of course became red with blood as he held them against his head.I grabbed and tossed away a couple of these towels before i realized the possibilities. I did not have any open cuts/entrances on my hands to speak of although i do bite my nails severely.What are my chances of infection if he is indeed infected? thankyou

Response from Mr. Sowadsky

Thank you for your question.

When giving a person first aid, care should always be taken to avoid contact with their blood. This is important in order to avoid a possible exposure to HIV, hepatitis B, hepatitis C, and other bloodborne diseases. You would be at risk for these diseases if:

1) The person was infected with a bloodborne disease, AND

2) You were directly exposed to the persons blood, AND

3) The persons blood got directly into your bloodstream through a fresh cut, open sore, dermatitis, or other breakdown in the integrity of the skin.

If you get blood on intact (unbroken) skin, there would not be a risk for these diseases. But if blood got directly into broken skin, there would be a risk of infection. The risks for hepatitis B and hepatitis C are even greater than the risk for HIV. The more blood you get exposed to, the greater the chance of transmission. If you have had a potential exposure to blood during a first aid situation, and the blood had a direct access to your bloodstream, it would be suggested that you get tested for HIV, hepatitis B, hepatitis C, etc.

When it comes to first aid issues, always follow these guidelines:

1) Take a course in first aid to learn how to properly and safely administer help to someone. Giving first aid saves lives!

2) Buy a first aid kit for your home, your office, and your car. Make sure that everyone in your household, and in your office, knows where the kit is located. The kit should be located in a place that is easily accessible, and is readily available for immediate use. Make sure the first aid kit is fully stocked at all times, and that items that have expired (for example aspirin and other pain relievers) have been replaced.

3) When an emergency does occur, if necessary, call for an ambulance, or other emergency services, as soon as possible (by calling 911 or the operator).

4) If the person is bleeding, always make sure you wear gloves (for example latex gloves) when giving someone first aid. A box of gloves should be a part of every first aid kit.

5) If gloves are not readily available, try to use any other type of barrier available to you (for example clothing, paper towels, etc.) as a temporary barrier. Although doing this may not offer complete protection, it can at least reduce the chances of you being exposed to another persons blood, or reduce the amount of blood that you are exposed to.

6) If you get blood on your hands, wash your hands immediately afterwards (or as soon as possible) with soap and water, or if available, a germicidal hand washing solution. You do not need to wash your hands with bleach (in fact, washing your hands with bleach can be potentially harmful to you). Washing your hands with alcohol may provide some benefit, but will not necessarily eliminate the risk of certain infectious diseases.

7) Consider getting vaccinated against the hepatitis B virus. This involves 3 shots over a period of 6 months, and should offer you lifelong protection against this disease.

Since I'm on the subject of first aid, let me now review with you about issues relating to mouth-to-mouth resuscitation and Cardiopulmonary Resuscitation (CPR).

1) Take a course in CPR. Giving CPR saves lives!

2) If a person is unconscious, call for an ambulance, or other emergency services, as soon as possible (by calling 911 or the operator).

3) If you are giving someone mouth-to-mouth resuscitation, keep in mind that the person may sometimes vomit (puke) while they are unconscious.

4) Exposure to saliva alone is extremely low risk for HIV and other bloodborne diseases, so giving CPR would normally be low risk. However, if the person has blood in their mouth (for example a car accident victim), or if there is blood in the persons vomit, then doing CPR may be risky for these diseases.

5) To avoid getting vomit and blood in your mouth, always use a one-way valve mask when giving a person mouth-to-mouth resuscitation These masks allow you to safely breath in the persons mouth, yet not be exposed to their vomit or blood. CPR classes should teach you the proper use of these masks. A one-way valve mask should be a part of every first aid kit.

6) If a one-way valve mask is unavailable, it is up to you if you want to start CPR or not. But remember, if there is no blood in the persons mouth or vomit, the risks of bloodborne diseases when giving CPR are generally low. At the very least, call for an ambulance as soon as possible.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).



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