Hello everyone, I'm a nursing student in Romania, first year. I've been going to the local emergency hospital for practice for about two weeks...and today, I think I messed up...really bad. A patient came in the emergency room, an elderly woman with a suspected hip bone fracture. After the hired staff were done with her, I was asked to inject something into the cannula (I don't recall what it was, seeing as I was, or still am, somewhat terrified). Oh man, how the heck do I even explain this...Well, the syringes here are of a such poor quality, that you have to use excessive force to inject or draw something. I start pumping, but the damn liquid won't go in, so I press harder and It slowly goes in. This is where I ****** up. The old lady suddenly moved her arm and as the syringe popped from the cannula, the liquid squirted all over my left arm and a bit on my face and right eye. The nurse who was supervising me laughed a bit, she said stuff like this happens when you don't hold the patient's arm tight. Right after this, I noticed the injection port of the cannula was somewhat covered in a tiny amount of dried blood. I didn't think much of it. The next minute when I looked over the observation sheet, I saw that word and letter...HEPATITIS C...and I froze. I ran to the bathroom, washed my arms and face, again. I didn't talk to anyone, say anything, I just left in a hurry and got home. As I write this, I still feel somewhat shocked at the idea that I might have gotten infected. It's about 6 hours later and I'm still shaking. Is it possible, even the slightest chance that I may have gotten infected?
orphanedhawk gave you some great information. Short and to the point.
I agree it would be very unlikely HCV to be transmitted from what you describe.
I would like to add something,
if I read your post correctly you are training to be a nurse? Anyway if that is the case you should know about infectious diseases and how they are transmitted. If I was to work in the medical field I would want to know the dangers of the job.
"Although a few cases of HCV transmission via blood splash to the eye have been reported, the risk for such transmission is expected to be very low."
Hepatitis C Information for Health Professionals
Hepatitis C and Health Care Personnel
Other than needlesticks, do other exposures, such as splashes to the eye, pose a risk to health care personnel for HCV transmission?
Although a few cases of HCV transmission via blood splash to the eye have been reported, the risk for such transmission is expected to be very low. Avoiding occupational exposure to blood is the primary way to prevent transmission of bloodborne illnesses among health care personnel. All health care personnel should adhere to Standard Precautions. Depending on the medical procedure involved, Standard Precautions may include the appropriate use of personal protective equipment (e.g., gloves, masks, and protective eyewear).
What follow-up testing is recommended for health care personnel exposed to HCV-positive blood?
For the source, perform baseline testing for anti-HCV.
For the person exposed to an HCV-positive source, perform baseline and follow-up testing, including
baseline testing for anti-HCV and ALT activity AND
follow-up testing for anti-HCV (e.g., at 4–6 months) and ALT activity. If earlier diagnosis of HCV infection is desired, testing for HCV RNA may be performed at 4–6 weeks.
Confirmation by supplemental anti-HCV testing of all anti-HCV results reported as positive by enzyme immunoassay.
Centers for Disease Control and Prevention
The CDC is one of the major operating components of the US Department of Health and Human Services .
Since you are a nursing student in Romania. I can not suggest that you report or not report this incident because of what may happen in your situation and career goals. It would be a good idea to check all patients charts and use recommended precautions
Of course if the HCV status of source is unknown then the odds are probably very extremely low in my guess. Since the source is confirmed the odds are still very low.
A few cases have been reported here is one
Transmission of hepatitis C by blood splash into conjunctiva in a nurse
CASE REPORT In the hemodialysis department at Dicle UniversityHospital, Diyarbakir, Turkey, a 23-year-old femalenurse splashed blood from a patient positive foranti-HCV and HCV-RNA into her face and eyes. Whenshe was exposed, she was taking blood froma peripheral vein in a patient with chronic renaldisease. She washed her eyes and face with waterimmediately. She reported the accident to hospitalmanagement and the hospital infection control de-partment. She had been completely healthy and hadnever used intravenous drugs nor received trans-fusion. She had not had a tattoo, needlestick accident,or any other risky contact in the last 6 months. Anti-HCV seropositivity by enyzme-linked immunosorbentassay and HCV-RNA by polymerase chain reaction.
both produced negative results. She had normal levelsof aspartate aminotransferase and alanine amino-transferase (ALT). Anti-HCV and HCV-RNA tests werepositive in the source patient. All of the laboratoryfindings of the nurse were found normal after 1 week,1 month, and 2 months.
After 6 months, the nurse presented with sore throat, nausea, vomiting, fatigue,and weight loss, which had started approximately 45days earlier and worsened. She had icterus on herconjunctiva. There was hepatomegalia in her physicaland sonographic examination. In laboratory tests, herALT level was 504 U/L, aspartate aminotransferaselevel was 388 U/L, total bilirubin was 2.3 g/dL, directbilirubin was 0.8 g/dL, and anti-HCV and HCV-RNAtests produced positive findings. She was hospitalizedfor monitoring.She was treated with 3 million IU of interferon alfa-2a/wk for a 1-year period. One month later the trans-aminase levels decreased to normal values. After 1 yearof treatment, her HCV-RNA test produced negativeresults and her transaminase levels were normal.
I see that you have been very active on this forum for many years and are doing a wonderful job. Please don't take my comment wrong or that it's directed at you alone.
There have been other comments similar to yours "you could not have been infected this way" i am sure i probably made some similar also and they are probably more than 99+% correct. But they may not be absolutely 100% correct.
I know very little about the tiny blood vessels in the eye or whether that contributes to a very low rick of transmission especially when the source blood is known to be infected with HCV.
It would be best to report this incident and follow the procedures that the hospital you work at recommend. As that other nurse said " this happens.." You are in a job that will put you at risk no matter how careful you are. Don't be afraid to take care of yourself by reporting it. My husband was in the hospital and a nurse stuck herself with a needle used on my husband. The hospital had to test my husband for a Hep and HIV as per protocol and found out my husband had a Hep C!!!! So the nurse had to get tested in a few months after the incident. It happen more then you can think and happens to experienced nurses as well. Please take care of YOU and report it and let us know what happens. Thank you for sharing the story with us, but know you are not the only one this has happened to. Okay???
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