HIV - Prevention Expert Forum
Hiv/hepatitis/STDs
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Hiv/hepatitis/STDs

Good morning-
I have some question and would like ur expert advice please. My son went in for an std test and the nurse/phlebotomist never switched gloves between patients. We r quite angry and this place was packed w people getting blood drawn.I noticed that the nurse or phlebotomist had a puncture/hole in her glove which she did not replace from the previous patient/patients. Now she had some red stain on her glove which could have been blood from the previous patient or it could have been blood from herself as she may have had a cut where blood had seeped thru her hole in the glove. If u could please answer each individually in regards to hiv/hepatitis or any other std:
1) if the phlebotomist did have a cut where blood seeped thru the puncture hole in the glove and she was in fact HIV/Hepatatis positive or had some other std could she have infected me if she touched the needle and accidently put on the needle before going into my arm. Im worried about the thought of her contaminating the needle before injecting it in my arm; and
2) if the previous patient had HIV/Hepatatis and got blood on the phlebotomists gloves and then touched the needle thereby contaminating the needle before injecting in my arm could I get HIV/Hepatatis or any other STD?
3) could the phlebotomist have infected me by touching my puncture wound with infected blood on her gloves from herself or the previous patient..Im sorry for the length and detail of the questions but im freaked out bc the nurse/phlebotomist never changed gloves from the previous patient and seeing red stain scared me. thank you.  
239123_tn?1267651214
Welcome to the forum. Thanks for your question.  I'm happy to help.

While I understand your concern to a certain extent, I really don't think your son or anyone else is at risk for HIV or other blood borne infections in this situation.  The main reason health personnel wear latex gloves when drawing blood is to protect the themselves from infections their patients may have, not the other way around.  Most clinics and medical offices would ask or require their personnal to put on new gloves for each patient, if only for appearances -- i.e. to avoid creating worries just like yours.  But blood drawing is inherently safe, and the potential for transmitting infections between patients is zero, assuming other basic precautions are used (clean needles, etc).

Your specific questions contain unrealistic scenarios that are not entirely dependent on glove use.  It is exceedingly unlikely any phlebotomist would touch the working end of a needle before inserting it (with or without gloves), or to otherwise let it be contaminated (e.g. touching a table top) after removing the needle cover; if either of these happened, the proper procedure would be to discard the instrument and start over with a fresh one.  Even if there were wet, contamined blood on a fingertip that touched the needle entry site, the chance of transmission would be exceedingly low, probably zero.

To my knowledge, nobody in the world has been reported to have caught HIV or hepatitis through blood drawing, except maybe a few 30+ years ago, when a few clinics in developing countries may still have been re-using needles.  This is despite the fact that probably billions of blood draws have occurred without glove changes between patients or without wearing gloves at all.

I think it would be reasonable for you to speak with the clinic manager and ask whether the phlobotomist is supposed to change gloves between patients, according to clinic policy; and tell her or him that on the day you were in the clinic, that wasn't being done.  If you do so, I would advise a calm and sober approach, in the spirit of friendly advice.

I hope this has been helpful.  Best wishes--  HHH, MD
9 Comments
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Avatar_m_tn
Thank u for Ur quick reply. Very appreciative.
Just to make sure if the phlebotomist touched either the sharp end of the needle or any part of the needle for that matter before injection into the arm or even if she touched the exposed puncture wound on the skin with her blood or the blood of a previous patient (that was infected of course w HIV or hepatitis or any Std) this would be considered a non-risk event?? Any brief explanation would be also appreciated. Thank u so much.
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239123_tn?1267651214
It doesn't seem productive to focus on very unlikely scenarios.  But even under those scenarios, the risk would be exceedingly low or zero.  There has never been a known case of HIV from blood coming into contact with a tiny wound like a needle puncture site; and the infections related to injury with sharp instrument involved either deep cuts with visibly contaminated scalpels; or injury with hollow needles with HIV contaminated blood inside.

I really don't think you should be at all worried about this event and do not recommend testing.  I would not be worried and would not be tested if I were in your circumstance.
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Avatar_m_tn
Thank u so much doctor. And I'm assuming ur answer goes for hepatitis and all blood borne diseases and stds.
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239123_tn?1267651214
Yes.
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Avatar_m_tn
Hi doctor. Was i supposed to be charged twice. My card was charged two separate 22dollar transactions. Sorry to bother.
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239123_tn?1267651214
Use the contact us link to send a message to the web administrator.  The moderators are uninvolved in billing etc.
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Avatar_m_tn
Hi doctor-

One last question- before posting my question to you I did read up similar questions but obviously wanted some answers to our direct circumstance to be fully confident which u have certainly done. But one comment that I've seen ur sled and dr hook repeatedly say is that transmission of hiv or other bloode borne diseases has only been known to come by contaminated blood that had already been inside the needle. What does that mean exactly? Do u mean the actual tube where blood fills into or do you mean inside the needle itself as I didn't know blood could get inside a needle? And when U actually say "puncture site or needle entry" is that the actual needle itself or actual site on the arm when the needle enters? Sorry to ask these questions but I just would like to know for myself and to explain to my son who is very nervous as well.
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239123_tn?1267651214
My guess is your son is nervous only because you are; if you had said nothing, my guess is he wouldn't be worried at all.  Please show him this discussion.

Blood inside a needle means what it says -- a contaminated needle that has been used on an HIV infected person, with wet blood still in the bore of the needle.

That will end this thread.  I would advise you ignore any and all additional "what if" scenarios that come to mind.  Nothing is going to change my opinion and advice.
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This Forum's Experts
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H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
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Edward W Hook, MDBlank
University of Alabama at Birmingham
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