Very superficial needlestick injury that did not bleed

[marthat]

Last week I accidentally stuck myself with a needle after using it on a patient.  I had on gloves and it felt more like I just barely nicked the skin on the palm of my opposing hand rather than puncturing the skin.  I removed my glove and washed the area and could not see a puncture or any bleeding.  Two days later I noticed a very small puncture wound where the needle had pricked my skin.  I did not report the incident at first, as I did not think it was a true needle stick.  Now it has been 4 days, so I don't even know if it is worth reporting and hate to look like an idiot for waiting to report the incident.  I am a young mother, so I am concerned about my well being for my children.  Since it was such a superficial ***** and did not even cause bleeding, are my risks even lower?

Thank you for your time.

[marthat]

1.  Ultra Fine Lancet

2.  60 year old female.  Per her questionnaire, she has not tested positive for HIV or Hepatitis.  Her medications do not reveal treatment for any of the above mentioned viruses.  The only notable history in her chart was a history of genital herpes.

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Hello,

You're welcome.

Without PEP.

You're also welcome to keep this line of communication open.

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

[marthat]

First of all, thank you so very much for offering your expertise.  I wanted to ask one more question.  If the risk from an HIV+ needle stick 0.32% with PEP or without PEP?

Thanks again for your time and help.

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Hello,

Your risk of HIV and Hep C should be discussed separately.

In general, the risk of acquiring HIV from a HIV+ individual after a needlestick is 0.32% (Gerberding 1996). The risk of transmission is increased for exposures involving larger amounts of blood, a deep injury, or if the source patient has a high viral load. The risk from mucous membrane and non-intact skin exposures is not zero, but is too low to be reliably estimated from the studies performed to date.

Based on what you have shared with me, your risk appears to be low based on the above factors.

So, your risk is not zero but extremely low and most experts would recommend against the initiation of PEP in your case; especially at this time.

With regard to Hep C, the risk that is quoted in the medical and scientific literature is 1.8% for a needlestick. Your risk is likely much lower than 1.8% based on the nature of your exposure.

I hope that this is helpful to you.

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

[marthat]

Sorry, one more thing.  She is a single female and travels a lot within the US for business.  She was presenting for a cosmetic procedure and did not appear to be suffering from any illnesses at present.

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Hello,

A couple questions before I respond to your question about risk.

1. What type of needle were you using? (gauge, etc)
2. Do you know anything about the source patient's HIV/Hep C status? (or risk factors?)

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.