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needlestick injury
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needlestick injury

Good day Doctor!

I'm working in ER. I got accidentally ***** by a used needle 2 days ago, it was a punctured wound but not too deep. I was not able to report the case to my charge nurse (which is a big mistake on my part). Now I'm getting worried. I checked the case of my patient, she as a 39-year-old diabetic, with morbid obesity and hypertension. She went to ED that time because of abdominal pain but was discharged on the same day from ED. Her liver enzymes are ok, no hepatitis blood works done.

My last hepa B antibody titer was April 2012, the value 624. No investigation was done after the injury because I did not report it. I am so worried about this that I can't even sleep properly. I'm so scared of HIV and hepa B/C transmission.

What am I going to do? I'm praying that the patient has no HIV/AIDS. Am I safe from getting the hepa B virus since I have the antibody? Help pls :(
Avatar_dr_m_tn
Hello,

If you are immune to Hepatitis B, there is very little chance of you acquiring Hepatitis B from a needlestick.

Some questions for you:
1. What gauge needle was involved with your needlestick injury?
2. Were you able to (and did you) express blood from the needlestick site?
3. Did you immediately cleanse the needlestick injury with soap and water?
4. When did you complete the Hepatitis B series (month/year)?

The estimated risk of HIV transmission is 0.3% after a needle stick injury and the estimated risk of Hepatitis C transmission is 2-8%. However, the answers to the questions above can affect the risk estimates and of course, the status of the source patient is an extremely important factor.

As you are likely aware, it is extremely important that you report needlestick injuries to your supervisor and that you seek medical attention (and advice) from your employee/occupational health provider.

~ Dr. Parks

This answer provided to you is not intended as and does not substitute for medical advice. The information presented in this Medhelp.org posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
3 Comments
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Avatar_f_tn
Thank you for the response. It's such a great info.

These are the answers to your questions:
1. vacutainer needle, i think t's like a gauge 24 needle
2. i was able to express blood and washed it with soap and water
3. hepa b series completed last sept 2005

I had my HbsAg and HIV screening done 1 day after the incident, bothe results were negative. But I know that I still need to follow up and redo the tests, but when should be my next screening test?

Thanks again and God bless always
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Avatar_dr_m_tn
Hello again,

Your answers (1-3) are all good news and decrease your overall risk.

In terms of follow-up testing, the recommendations from CDC are:

1. Hepatitis C: You should be tested for HCV antibody and liver enzyme levels (alanine aminotransferase or ALT) as soon as possible after the exposure (baseline) and at 4-6 months after the exposure.
2. HIV: You should be tested for HIV antibody as soon as possible after exposure (baseline) and periodically for at least 6 months after the exposure (e.g., at 6 weeks, 12 weeks, and 6 months).

***Hepatits B: Did you have a titer (HbsAb) performed in 2005 (or after this recent exposure) to determine if you have immunity to Hepatitis B? This is important.

Many clinics will screen for HCV on the same schedule as HIV (see #2) and test out to 9-12 months.

~ Dr. Parks

This answer provided to you is not intended as and does not substitute for medical advice. The information presented in this Medhelp.org posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
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Philip D Parks, MD, MPH, MOccH, F...Blank
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