Occupational exposure - possible

Question

I am a nurse, and work with many HIV infected patients. Today, I took care of a patient who has AIDS with a high viral load, and is also neutropenic. I walked into his room and noticed his blood transfusion was completed. I disconnected the tubing from his heplock, and blood splattered all over the front of my scrub top and onto my wrist. My wrist has no cuts or scrapes, but a pretty large pool of blood was sitting on my skin for at least 20 seconds before I could wash my hands and arms. Also, I walked around with the dirty scrub top for the rest of the day. For the first 10 minutes, I could feel wetness from the blood against my skin (again, no cuts on my stomach where the blood may have soaked through). Although the blood was likely from the donor, my patient's IV kept backing up and I believe some of his blood could have been mixed with the donors'. What is my risk? Sorry, I know the risk is low, but I just need to have my mind eased, I'm already losing sleep. Thank you for your time.

Answer

Hi,

The HIV-acquisition risk from the occupational exposure you describe is nonexistent. HIV cannot permeate intact skin (unless it's a site of a previous herpes breakout).

As with all occupational exposure, you should report and document this incident. However, I see absolutely no cause for alarm.

By the way, why did you walk around in your blood-spattered scrubs for the rest of the day. It may not be an HIV-acquisition risk, but it is a really bad fashion statement!

Dr. Bob