concerned about possible needlestick

Question

Hi Dr Bob,

I'm a OR nurse who is really worried about a possible sharps injury. While scrubbed in during surgery, I think I may have punctured my gloves and finger with a sharp retractor that had been used in the patient. I didn't see any holes in either of my gloves (I always wear two pairs) and it appeared the my skin was intact as there was no bleeding or any visible punctures. I wasn't even sure whether or not I was stuck so stupidly, I didn't follow up with occupational health immediately and now my exposure is being treated as an unknown source exposure. I initially tested negative to hiv and hep C but will be tested again at 6 weeks, 12 weeks, and 6 months.

I know my risk is very low but I'm worried about the possibility of having either hep c or hiv that will not show up on tests at 6 mo. My long-term and committed partner is really worried as well- we plan on being as safe as humanly possible (condoms, barrier methods for oral sex, no deep kissing if either of us have any mouth sores) until 6 month results are back. Do you think this is over-vigilance or would you recommend proceeding the same way? Also, do you think its necessary to wait 6 months as the majority of people test positive for hiv in 3 months?

I'm sorry if these seem like silly questions and I really really really appreciate you getting back to me! Thank you so much again!

Answer

Hello,

You are not sure whether you were stuck. You did not see any holes in either of your two paris for gloves. Your skin was intact and there was no bleeding or any visible punctures. Tell me again why you are so freaked out. As I have mentioned very frequently in this forum, all potential occupational exposures should be reported immediately. Had you done so, you would not be stressing out now.

Your concerns about having either hepatitis C or HIV that would not show up on a six-month test are completely unwarranted. Why would you even worry about this?

Do I think you are being "over-vigilant," absofrickenlutely!

Your plan for HIV screening at 6 weeks, 12 weeks and 6 months is appropriate for an occupational exposure (or potential occupational exposure).

Good luck.

Dr. Bob