blood splash into eye

Question

I am a resident physician working in the ER when got blood splash into my eye. I was stitching a wound when my hemostat snap b/c I didn't click it into place and might got blood splash into my eye. The patient is 24 yrs old and married, but unknown HIV/AIDS status. What are the possibility that I might contract this disease? My attending told me not to worry about it. What should i do? Thank you for your time.

Answer

Hello,

The ER in which you were working as well as the residency program in which you are training should both have written policies and procedures for possible occupational exposure to bloodborne pathogens. Generally this would involve your being seen at the occupational health department, completing an incident report and being seen by a physician trained in the proper evaluation and management of occupational exposures. The Department of Health and Human Services and CDC have published guidelines, which can be downloaded at http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. If you did get blood into your eye while performing a procedure, often the source patient will agree to be tested for bloodborne pathogens. Regarding HIV, if there was significant exposure, PEP (post-exposure prophylaxis) may be warranted, but must be started as soon as possible and no later than 72 hours after the exposure. If the exposure was questionable, HIV testing immediately and at three and six months is recommended. Even if your attending advised you not to worry, I would still have the incident documented and properly evaluated. In addition I'd review the policy, procedures and published guidelines for the evaluation and management of occupational exposures to bloodborne pathogens (HIV and hepatitis).

Good luck.

Dr. Bob