[Question #8653] Needle injury due to OCD
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41 months ago
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Hello doctors, it’s me again thank you for this forum it’s been a great help the last time.
I have a situation today while I was inserting IV needle 20 Gauge to a 69 years old female Saudi patient, she is married with 3 daughters, has a clean record in the ministry of health department and the hospital it’s self also I asked her later and she says she is clean of anything.
Here is the situation:
While I was inserting the needle I felt something it’s was not painful but my ocd tells me it’s needle injury, its might be the catheter its might be normal feeling might happens. I know its nearly impossible that’s I touched the needle because I will know it for sure it’s will be painful as heel and I will notice and remove the needle from my finger. Also I will watch the needle but it’s was I believe still inside the patient because I was still pushing the catheter, then I removed the needle after pressing the safety button. It’s impossible to get needle prick without seeing the needle around you.
I’m concerned and confused and don’t know what to do, my colleague and the nurses said to me don’t worry. They saw no necessary action should be taken.
The iv failed anyway I pressed my finger for 5 minutes after no blood coming out my finger looks intact expect little scratch you can’t notice it at all could be before or after I opened new needle to experience the situation again.
My quastions is :
1- will you fell the needle stick and know if for sure that’s you got one? You will see the needle for sure I didn’t see any it’s was probably inside the patient.
2- there is no blood coming out from my finger after squeezing and pressing so hard for 5 minutes does that’s mean there was no needle prick?
3- it’s hard to get needle injury for the iv insertion because you can’t remove the needle, there is a safety button that’s the needle go inside, I always do that.
4- what do you think I should do or what you believe it’s happened?
5- what’s it the needle stick anyway? Should it’s penetrate? I
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41 months ago
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There was no penetration at all, that’s something for sure.
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Edward W. Hook M.D.
41 months ago
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Welcome back to our forum although I’m surprised you felt the need. Many of the responses I am about to provide are similar to the responses you received from Dr. Handsfield three months ago and the facts surrounding exposure such as the one you describe Have not changed. If anything, this exposure was lower risk then the risk you reached out to us about three months ago. The chance that your patient was HIV infected is virtually zero, there was no puncture or blood drawn. I would have no concerns whatsoever about this exposure, would feel no need to test, and would not change my behavior towards my loved ones in anyway. To answer your specific questions:
1. Yes, if you experienced a needle stick you would certainly feel the prick and for HIV transmission to occur the needle would need to drop lot which apparently did not occur in this case.
2. Correct
3. Understood. I agree
4. I would have no concern about the incident you describe whatsoever. I do know that you don’t mention whether or not you were wearing gloves and wonder if you were. You should have been
5. “What if” questions such as these serve no purpose.
To summarize, the incident you describe was a no risk event involving a very, very, virtually no risk patient. I would have no concerns and I see no reason for testing. Please don’t worry. EWH
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41 months ago
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Thanks doctor for clarity, it’s was much needed and relief.
The last test I had was a year ago so I think test now will make me feel better and maybe help me with irrational thinking and OCD. So I have additional question regarding tests,
1- it’s okay to wait for a 10 days now and do (NAAT Or PCR test) ? I heard it’s definite after a week to 10 days.
2- I’m planning to do this test and Combo Ag Ab at the same time to make me feel Better it’s wrong?
3- as I understood as long I don’t have sex with unknown partner or shared drugs or to have obvious and known needle sticks I will be fine?
4- one of my friends want to me to ask you he was smoking hookah and one of the flame has been dropped on the ground while a lot of people walking, he took it and smoked it it’s a risk?
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Edward W. Hook M.D.
41 months ago
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1. Many experts say that HIV NAAT test is definitive at any time more than 11 days but, out of caution would follow that with a 4th generation combination HIV antigen/antibody test at 6 weeks.
2. 10-11 days is too soon for a combination test
3. Correct
4. No risk
EWH
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41 months ago
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Thanks doctor for clearing everything out, everything clear for me now.
I have additional questions just for knowledge:
1- I have a condition I think it’s called angular cheilitis, it’s just comes and go in one side of the mouth, it’s happens like 4-5 times in the last 3-4 months, I’m wondering if it’s indicate something? I smoke hookah everyday and I’m stressful person and also I wear dentures.
2- is getting scratch in the public that’s does not cause bleeding a risk for hiv? Even after hiv patient?
3- does touching blood in an intact skin a risk for hiv? Or a skin that’s have cracks but does not bleed.
4- there is objects that’s simply doesn’t penetrate the skin and exposed to ear like a pin for example does getting prick by these object cause a risk? Even if it’s contain hiv blood?
5- finally if someone insert there finger in another person ear is this a risk? It’s happened while ago with a doctor after a surgery and I didn’t check if her hand contain blood.
6- is sharing hookah pipe with someone a risk? With respect if there is unnoticed blood.
Thanks doctor, it’s been a great help.
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Edward W. Hook M.D.
41 months ago
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As you know, we provide up to three responses to each clients question. This is my third response. Thus, this thread will be closed shortly after this response is sent:
1. Angular colitis is a minor, superficial fungal infection. It is really treated. It is not necessarily a sign of a more serious illness.
2. No.
3. Touching contaminated blood with intact skin or skin which may have minor abrasions is very, very low risk and while could theoretically lead to acquisition of HIV, in reality this almost never curse. It is not a major concern although obviously, avoidance of direct contact with blood is always advisable
4. Transmission of HIV through needle sticks or punctures requires the injection of the contaminated blood deep in the tissue to cause infection.
5. No, someone inserting their finger at someone else is here it’s not a risk for a HIV.
6. No
Is completes this thread. Please don’t worry so much. HIV is more difficult to transmit than you seem to think. Take care. EWH
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