HIV Risk Assessment

[FreshRN1984]

I have a few question in regards to an occupational exposure. Let me explain my situation. I am a healthcare worker and had a patient with a PICC line. He was running antibiotics and IV fluids for most of the day using the blue port of the PICC line. A lab was ordered and I tried using the other port to draw a lab, but upon initial assessment, the line would not flush with normal saline. I clamped the port and decided to use the existing port that the patient was using for IV fluids and antibiotics. I stopped the IV machine, disconnected the IV lines, and clamped off the blue port of the PICC. Before proceeding with drawing the lab from the blue port, I flushed it with 10 mL of normal saline and clamped off the line again. I then removed the blue cap that was on the line, so that I could connect a luer-lok vacutainer for initial waste draw followed by the actual lab draw. Upon removing the blue cap though, I felt droplets of fluid hit my face (not sure if it hit my eyes), but didn't think much of it because I clamped the port, flushed with 10 mL of saline, then clamped the port again. I proceeded to connect the vacutainer etc. and did not consider this something worthy of reporting as an exposure. I also checked the patient history on the medical record and no history of HIV. A few questions come to mind. First, if any fluid mixed with blood did hit my eyes, what would be my risk for HIV? Was I at risk at all? Again, the droplets that I was exposed to were before connecting the luer-lok for sample draw and the line was clamped. In my scenario, would I have even been exposed to any kind of normal saline mixed with blood? Is HIV testing required? Thank you to all community members who provide their input!

[nursegirl6572]

I responded to your PM.

[FreshRN1984]

Nursegirl6572, thank you for your response. I asked and informed a physician from another forum about the situation that I posted above. Recommended that I seek out PEP protocol at the hospital that I work at. You think that is overkill? I reiterated the fact that I flushed and clamped the PICC line and that the splash of droplets I felt were previous to the lab draw. Even when I hooked up the tube for lab draw, it took a short while before any blood and blood return was visible in the line. I felt that it was normal saline that hit my face. It is to my understanding that a risk would have been involved if it was a copious amount of blood that hit my eye directly. Also the patient was hospitalized for a repeat infection in his groin and upon checking his history the following day after the incident, no HIV history was found. Kind of put other things together considering his age and that no anti-viral medications were listed for administration. Thank you again for your knowledge on this situation.

[FreshRN1984]

Thanks for your response bmthbloke. I checked the patient history on file the following day and no history of HIV was present.

[nursegirl6572]

I don't see any cause for concern at all.  You can always run it by your employee health department, but I don't see a need for testing.

[bmthbloke]

Is regards to hiv there is no risk.

It would say in the patients notes if they had hiv. At my hospital it would he on a big red page.

Even of they did the virus would die outside the body.