[Question #6131] Blood draw nurse cut on nurse hands (dr hook ) request

19 months ago

Question slightly long Because I have answered some myself from medhelp . Some answers given in point 4 and 5 
Dear doc hook I’m young female mother TOOK ME 12 days to ask a Question we don’t have paypal in this country of mine . So I have deserved your time doctor hook plz it’s a request . 

I need your expert help as per medhelp which doctor Hunter must agree . 

I did a blood test needle was new . However nurse had holes in one glove  she said it Was to take feel of vein.

My concern summary : nurse has cut /wound on finger and blood got out of finger becase of holes in  gloves on  and blood got on needle /middle surface area  . And the gauze is no risk for hiv hepatitis b c . And also if nurse touched the pointy end(hollow part)  of needle when removing needle cover 

1) I know you have said on medhelp if nurse touched needle ( the sharp pointy end hollow  ) is no risk for hiv hepatitis b c so risk .  so surely below points are not at risk as well 


 I have one fear when needle middle area of needle(outside of the needle)  got inserted/pushed back  into my arm when nurse was removing/withdrawing needle from my vein  . Nurse was struggling to withdraw the needle because I applied pressure on gauze   so I feared the needle middle / surface  got pushed back into me a little
 and used an over size big gauze which covered the butterfly needle and the wings . Nurse has zero visibility.so I could not see her hands 
2)) surely this is also no risk  main cocern is only when I feared nurse has cut on finger and her bleeding finger  touched (middle or base surface of needle )when she was withdrawing needle from my vein . And if the needle surface/middle(not the pointy end )   area slightly re inserted  pushed into my arm . 

3)  if her exposed finger which has cut and her bleeding finger got blood on gauze .  Please note gauze is applied on the needle (injection site) and gauze touches the needle surface and then needle is withdrawn . so fear is needle surface/middle  area where gauze was applied got re inserted/ pushed  into my arm when nurse struggle a little to withdraw needle from my vein .  Because nurse bleeding finger might have got blood on gauze . 

Can you explain in point 2 &3 why needle surface area if had blood on it cannot go into vein even if  middle /surface area of needle was pushed  into my arm . Is it because my body will produce negative pressure and won’t allow blood to enter  even if the needle middle area went Into my arm I read that on mehdlep  ?please note blood is on outside not inside of needle . and the needle was never fully withdrawn from me . 

Have you understood what I’m tying to say ? 



Some answers I give myself : 
4)why all of the above (1 to 3)is no risk : you have said doc hook that hiv hepatitis b c are not transferred by the hands and even if nurse has cut/wound  on her finger and her  bleeding finger got blood on needle surface or gauze . Any blood that was leaving nurse hands has been. Exposed to the environment and thus hiv hepatitis b c becomes non infectious and are dead . 
So even if nurse bleeding finger touched base of needle  or even if the pointy end of needle or gauze and blood leaving nurse bleeding finger was exposed to environment was dead for hiv hepatitis b c  that’s it . This is all I need to know why I’m not at risk 

5) doc hunter says nobody gets hiv hepatitis b c from mistakes made from blood draw  as long as needle not reused . so my needle was new even if mistakes were made I’m not risk for any virus . also you can’t get these viruses from contaimaintated environment. So surely if nurse hand had a cut and blood got of her bleeding finger it would be considered contaimanted environment and thus no risk for hiv hepatitis b C  


if anything you did not understand I will repeat and just clarify point 2 and 3 needle insertion point thanks 
Can you reply to point by point and also I don’t want to fear blood draw ever again in my life is it safe to breast feed my child ?

19 months ago
Info missed : blood draw was done using a butterfly needle and my over size gauze covered needle and the wings so had zero visibility for nurse and me 

Point to remember :Needle was not fully withdrawn just fear that it got slightly pushed back into my arm. 
19 months ago
Please note :  we have to say /assume   that nurse has hiv hepatitis b c so as per medhelp when any blood leaving nurse finger would be exposed to air and would be dead for hiv hepatitis b c (non infectious ) .  So please do say in your reply on point number 4 . That assuming nurse is has all these viruses (hiv hepatitis b c ) thank you 
Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago
Welcome to our Forum.  By chance I have picked up your question.  Dr. Handsfield and I share responsibilities for answering questions on the Forum.  As you know, we never disagree on the substance of our recommendations.

As I prepare to answer your questions, I must first correct a misunderstanding which many of our clients have. Health care providers are recommended to wear gloves when drawing blood or touching wounds to protect themselves, not to protest patients from them.  There are not instances which I am aware of in which patients have acquired HIV or hepatitis from health care professionals who were drawing their blood or touching a puncture (needle stick) or other wound.  Now, on to your questions:

1. Health care providers are trained to NOT touch needles including needle tips.  In the unlikely event that your nurse touched the tip or side of a needle that was used to draw your blood, there would still be no risk for infection unless the needle had punctured the nurse and was carrying their fresh blood when your blood was taken.  the situation you describe was a no risk event.

2.  There is no risk for HIV or hepatitis from the nurse touching the side of the needle, even if she had blood on her finger and the needle was re-inserted (all of this circumstance in most unlikely).

3.  The same if there was blood on the gauze used to cover your puncture wound as the needle was withdrawn.

4.  You have answered this question yourself. These viruses become non-infectious on exposure to the environment.  Further the viruses would adhere to the material on the gauze not pass through.  Finally, please realize that there are no proven instances in which HIV or hepatitis has been transmitted under the conditions you describe.  This is simply not a scientifically realistic concern.

5.  Correct

All of these answers have been provided accepting your unlikely assumption that the nurse had hepatitis B, C or HIV.  I really think however you are worrying needlessly.  I hope the assurances I have provided will help relieve your concerns.  EWH
---
19 months ago
Thank you 
Probably because I have new born baby I just  read your point on medhelp so that’s the only thing I was reading I stopped reading anything else so can I just focus on one point which you just confirmed 

i  will be repeating only one point from medhelp and I’ll think I’ll just stick with this point as this really helped and make summary Because only your point helped me  and I don’t want to be misguided by anyone else. Will over come my fear with this point

Below points is assuming and saying if nurse has hiv hepatitis b c why it’s no risk 

1) you have  said doc hook medhelp that hiv hepatitis b c are not transferred by the hands and even if nurse has cut/wound  on her/his finger and her/his bleeding finger got wet blood on needle surface or gauze or needle hollow  sharp area  . Any wet  blood that was leaving  /coming out of nurse hands because nurse may have a cut/wound will be . Exposed to the environment and thus hiv hepatitis b c becomes non infectious and are dead if the nurse has hiv hepatitis b c 

So even if nurse bleeding finger touched base of needle  or even if the pointy hollow front of needle(the end that penetrates the skin )  or gauze  or bandaid and got wet blood on them any wet blood leaving nurse bleeding finger is being exposed to environment  and that wet blood would be dead for hiv hepatitis b c  that’s it . This is all I need to know why I’m not at risk assuming  nurse has hiv hepatitis b c 


2) Summary idea taken from medhelp  :  IF  nurse has hiv hepatitis b c simple only one point to remember from medhelp  that any wet  blood leaves nurse bleeding finger if nurse has a cut or wound  that wet blood coming out of nurse hand /finger  will be exposed to environment  and hiv hepatitis b c will become non infectious / dead and will not be able to infect me .  so that is why she can touch gauze band aid or unlikely worst case scenario needle side  or needle pointy hollow sharp part(that penetrates the skin )   . assuming if nurse has hiv hepatitis b c 

3  So in my  case that  is why even if i think nurse has cut on hand/finger and wet  blood coming out of nurse hand /finger  got on side of needle even if needle got REINSERTED  /PUSHED back into my arm is no risk for hiv hepatitis b c when  muse was trying to withdraw the needle  from my arm ?  if nurse has hiv hepatitis b c 

4this is why you also said not to worry  on Medhelp even if nurse touch the pointy hollow end of needle (which penetrates the skin ) when nurse remove needle cover.  .if nurse has cut on hand and wet blood was coming out of nurses hand  .that wet blood would be dead for hiv hepatitis b c . So no risk even if wet blood went into the needle from nurse hands if she touched the pointy sharp  hollow part needle. ( which penetrates the arm )  and then nurse drew blood  . As you say on Medhelp 

assuming nurse has hiv hepatitis b c 

5)final point as you say on medhelp  if nurse has hiv hepatitis b c any blood leaving /coming out of  nurse finger /hand  is non infectious / dead for hiv hepatitis b c and that is why I we should not care what the nurse touches such as gauze , band aid , needle surface or pointy sharp hollow part needle . And also that is why you repeatedly say hiv hepatitis b c are not transferred by the hands 

6) I’m not at risk for any virus for hiv hepatitis b c no need for testing ? .  may I never fear nurse hands ever again ! . with the events I have told you and will be never be at risk in future blood draws as long as I make sure the needle was new regardless of what nurse hands touches 

Reason why I have repeated this point is because I do not want to inertnert to scare me and I’ll stick with your point on hands .because no one will help So you understood completely my point on hands and I won’t need to check nurse hands in future 




19 months ago
Just to be clear you read in the beginning that nurse has HOLES IN GLOVE . That is why I’m treating this as nurse bare finger/ hands even if it has cuts and touched gauze needle side etc  . Any blood leaving nurse finger hand is dead for hiv hepatitis b c . As written above which I copied from medhelp . 
Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago
I understand that when one has a baby to care for our concerns get more intense.  Your follow-up questions however are rather repetitive.  I'll go straight to your follow-up questions:
1.  Your summary is correct.
2.  Correct.  In addition, simple surface contamination of the sort you might get from a tou8ch or from gauze does not lead to infection- the virus needs to be introduced deep into tissue.
3.  As I have said before the situation you describe is incredibly unlikely but your "what if" summary is correct based on the information you have provided.
4.  Correct, simply touching the shaft or tip of the needle before it went into you would not put you at risk.
5.  Correct.
6. Correct, nothing you have described suggests a risk for HIV or hepatitis. There is no medical need for testing related to the situation you described.  

I understand that th nurse who drew your blood had holes in her gloves.  

I hope this verification of my earlier responses is helpful and you will not feel the need to repeat these questions again.. The answers are not going to change.  EWH
---
19 months ago

Yes thank you for kind reply it is because I did not want to discuss this point with any other doctor they Mis guide so as you know this is last reply . I want to make my summary so that I can remind myself in future but I want to add the hole in glove or no glove part .


1) my summary is correct I know as you said on med help but I would like to add the holes in gloves part which I did in the beginning of question  it  basically means the nurse bare finger/hand  was out with no glove protection you can just think NO gloves were used by nurse and she did my blood draw  . And I said nurse finger has cut /wound and wet blood Coming out  of nurse bare finger / hand  will be exposed to environment thus hiv hepatitis b c wil be dead  and then nurse got wet blood on gauze , bandaid , touched needle base or tip because of nurse bleeding finger / hand had a cut or wound  . assuming nurse has hiv hepatitis b c . 

2) so you can just think of nurse  bare hands were used  with  no gloves during blood draw that would give a clear idea  . Instead of saying holes in gloves . Even if they’re were no gloves used . My summary Will stand because any wet blood leaving nurse finger hand if nurse has cut or wound . will be exposed to environment  and that  wet blood will be dead for hiv hepatitis b c  ,Even if no gloves were used during blood draw  . I will still be safe because any blood leaving nurse finger is exposed to environment as is dead for hiv hepatitis b c . Even if nurse bleeding finger/hand  touched and got blood on the needle side area when removing from my vein and needle got re inserted into my arm  or gauze or needle tip or bandaid . so I’ll never be at risk with the blood draw 

3) my final summary idea taken from medhelp  :  IF  nurse has hiv hepatitis b c simple only one point to remember from medhelp assuming nurse has NO GLOVES during my blood draw and are just using bare hands  any wet  blood leaves nurse bleeding finger if nurse has a cut or wound  that wet blood coming out of nurse hand /finger  will be exposed to environment  and hiv hepatitis b c will become non infectious / dead and will not be able to infect me .  so that is why even if nurse bleeding finger touched and got wet blood on  gauze band aid or unlikely worst case scenario needle side  or needle pointy hollow sharp part(that penetrates the skin ) hiv hepatitis b c will be exposed to environment and will be dead   . assuming if nurse has hiv hepatitis b c . So I will never be at risk at blood draw 

4) whatever I said on all the above responses and the previous two responses  That nurse fingers /hand were out  and there was no glove / glove was ripped and bare fingers were out . You can just think like no gloves were used okay and nurse did blood draw with bare hands and no glove used Even still my summary will stand meaning wet blood leaving nurse hands if nurse has a cut or wound on hand /fingers  is dead for hiv hepatitis b c . so no risk for hepatitis b even if nurse touched all the equipment and got wet blood on them 

5) So in future doc even if I fear nurse has cut on finger and blood coming out of finger / hand  and nurse has hole in gloves or the glove is ripped and nurse bare hand /finger is exposed with no glove protection . Even if I fear wet blood is coming out of  nurse hand because she has cut /wound that wet blood coming out of nurse bleeding  finger /hand   is dead for hiv hepatitis b c . So I should not fear nurse hands anymore and I should tell myself any blood coming out of nurse hands is non infectious hiv hepatitis b c and let her touch the whole equipment . and this is what we mean when we say hiv hepatitis b c are not transferred by the hands even if nurse has cuts /bleeding finger 

6) and finally no risk for even if needle for re inserted when nurse bare bleeding finger for touch the base of needle /middle when it went into my arm when she was trying to withdraw the needle . So whenever nurse removes the needle In future there is no need to panick.even if I think needle middle area got reinserted into me .  Also would the negative pressure of my body not allow any blood to enter if blood was on needle surface area when nurse touched it with her bare finger . ?

7) just remind yourself nobody gets hiv hepatitis b c from blood draw . Just make sure needle is new and don’t worry about nurse touching needle , gauze , Bandaid even if she has cuts on her hands (bleeding finger ) with gloves or no gloves / or holes in gloves . Or any other mistakes being made I can think of 

8) I don’t need hiv hepatitis b c testing on things I have described today even with holes in glove of nurse or no gloves used at al during blood draw 

Goodbye part : below 
As you know this is last post it took 12 Days for to get a question . I won’t get tested Thanks to you . 

If I want to just ask Or just polish any of my wordings on hands in future Which I think I dont need to . May I just ask for a besponse in future just in case I need to talk about one point in nurse hands . So nothing new to add at all my confidence is good  Thanks a lot . But please see above if I make any small mistake in spelling I would like to just ask you again in hands . Just polish a word or two .not now but well in future . This way I will save myself from excessive worry . 

thank you and good bye .BUT please do see my summary and respond I just added no gloves used  . That’s what i meant . If make spelling mistake on summary I’ll just clear it out not now a month later or few days later  . Just so that you are not  but I think I don’t need to if you read all the above . 

Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago
I'm sorry that you felt the need to repeat yourself again.  I completely understand that the nurse's finger was uncovered while she drew your blood. This was considered in all of my responses.  There is no need for concern and no need for testing for hepatitis B, C or HIV related to the events you describe.

This completes this thread.  There will be no further responses.  EWH
---
19 months ago
So please do respond on my polished summary point by point with added word seems and it’s same thing but just I added Hole in glove or no gloves used at all during blood draw 

Thank you for great work