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should I worry about hepatitis c?
should I worry about hepatitis c?
About 2 weeks ago, during a night-time shift, I was suturing up a deep
wound on a patient. The patient was a male, and a chronic IV drug
user. He was Hep C - positive, had liver enzymes drastically higher
than normal, and had just started taking the meds for hep C
treatment.
His wound at the time was bleeding heavily.
When suturing, I passed the suturing needle from one side of the wound
to another with my fingers. I do remember having grabbed the sharp end
of the needle in the middle of suturing and then stuck it into the
other side of the wound. ( all using my fingers instead of a
hemostat )
I wasn't injured ( at least not to my knowledge; maybe I was stuck
"microscopically" ? ) in the process. I didn't bleed and gloves were
not visibly punctured, although I remember grabbing the suturing
needle by its sharp tips. It was a pretty stupid thing to do.
Is this an occupational exposure? Should I worry about having
contracted Hep C ?
About 2 weeks ago, during a night-time shift, I was suturing up a deep
wound on a patient. The patient was a male, and a chronic IV drug
user. He was Hep C - positive, had liver enzymes drastically higher
than normal, and had just started taking the meds for hep C
treatment.
His wound at the time was bleeding heavily.
When suturing, I passed the suturing needle from one side of the wound
to another with my fingers. I do remember having grabbed the sharp end
of the needle in the middle of suturing and then stuck it into the
other side of the wound. ( all using my fingers instead of a
hemostat )
I wasn't injured ( at least not to my knowledge; maybe I was stuck
"microscopically" ? ) in the process. I didn't bleed and gloves were
not visibly punctured, although I remember grabbing the suturing
needle by its sharp tips. It was a pretty stupid thing to do.
Is this an occupational exposure? Should I worry about having
contracted Hep C ?
Re: should I worry about hepatitis c?
On Sat, 04 Aug 2007 05:46:00 -0700, dacconverter <seagate1556@hotmail . com >
wrote:
>
>About 2 weeks ago, during a night-time shift, I was suturing up a deep
>wound on a patient. The patient was a male, and a chronic IV drug
>user. He was Hep C - positive, had liver enzymes drastically higher
>than normal, and had just started taking the meds for hep C
>treatment.
>
>His wound at the time was bleeding heavily.
>
>When suturing, I passed the suturing needle from one side of the wound
>to another with my fingers. I do remember having grabbed the sharp end
>of the needle in the middle of suturing and then stuck it into the
>other side of the wound. ( all using my fingers instead of a
>hemostat )
>
>I wasn't injured ( at least not to my knowledge; maybe I was stuck
>"microscopically" ? ) in the process. I didn't bleed and gloves were
>not visibly punctured, although I remember grabbing the suturing
>needle by its sharp tips. It was a pretty stupid thing to do.
>
>Is this an occupational exposure? Should I worry about having
>contracted Hep C ?
Of course "it" would be classified as an occupational exposure - assuming you
weren't moonlighting at the time ;-)
The real question is: what exactly is "it".
If you didn't puncture your glove, "it" is nothing.
If you *did* puncture your glove - microscopically or otherwise - "it" could
still be nothing, but "it" could also be something, and you won't know which
"it" is until you get an HCV antibody test.
Bottom line: after four weeks from the incident, get an HCV antibody test,
regardless of what you think actually happened. It usually takes a few weeks
for antibodies to be expressed in sufficient quantity to register a positive
result, so testing too early may provide a false-negative result.
With any luck, "it" will turn out to truly be nothing.
Cheers
/greyhackles
On Sat, 04 Aug 2007 05:46:00 -0700, dacconverter <seagate1556@hotmail . com >
wrote:
>
>About 2 weeks ago, during a night-time shift, I was suturing up a deep
>wound on a patient. The patient was a male, and a chronic IV drug
>user. He was Hep C - positive, had liver enzymes drastically higher
>than normal, and had just started taking the meds for hep C
>treatment.
>
>His wound at the time was bleeding heavily.
>
>When suturing, I passed the suturing needle from one side of the wound
>to another with my fingers. I do remember having grabbed the sharp end
>of the needle in the middle of suturing and then stuck it into the
>other side of the wound. ( all using my fingers instead of a
>hemostat )
>
>I wasn't injured ( at least not to my knowledge; maybe I was stuck
>"microscopically" ? ) in the process. I didn't bleed and gloves were
>not visibly punctured, although I remember grabbing the suturing
>needle by its sharp tips. It was a pretty stupid thing to do.
>
>Is this an occupational exposure? Should I worry about having
>contracted Hep C ?
Of course "it" would be classified as an occupational exposure - assuming you
weren't moonlighting at the time ;-)
The real question is: what exactly is "it".
If you didn't puncture your glove, "it" is nothing.
If you *did* puncture your glove - microscopically or otherwise - "it" could
still be nothing, but "it" could also be something, and you won't know which
"it" is until you get an HCV antibody test.
Bottom line: after four weeks from the incident, get an HCV antibody test,
regardless of what you think actually happened. It usually takes a few weeks
for antibodies to be expressed in sufficient quantity to register a positive
result, so testing too early may provide a false-negative result.
With any luck, "it" will turn out to truly be nothing.
Cheers
/greyhackles
Re: should I worry about hepatitis c?
On Aug 4, 6:34 pm, greyhackles <greyhack...@NOSPAMyahoo . com > wrote:
> Of course "it" would be classified as an occupational exposure - assuming you
> weren't moonlighting at the time ;-)
>
but is this something that I should report to the hospital's
occupational safety unit?
I may have grabbed onto the sharp end of the suturing needle but I
didn't necessarily stick myself. I didn't have a visible hole on
either glove and I didn't bleed or get any skin tears.
I don't know if my experience qualifies as an occupational exposure
defined by my hospital.
Also, this patient had extraordinarily high liver enzyme volmes
( would this usually correlate to high hcv viral loads? ) , and I'm
not sure if this justifies my worries in that I might have contracted
hcv.
On Aug 4, 6:34 pm, greyhackles <greyhack...@NOSPAMyahoo . com > wrote:
> Of course "it" would be classified as an occupational exposure - assuming you
> weren't moonlighting at the time ;-)
>
but is this something that I should report to the hospital's
occupational safety unit?
I may have grabbed onto the sharp end of the suturing needle but I
didn't necessarily stick myself. I didn't have a visible hole on
either glove and I didn't bleed or get any skin tears.
I don't know if my experience qualifies as an occupational exposure
defined by my hospital.
Also, this patient had extraordinarily high liver enzyme volmes
( would this usually correlate to high hcv viral loads? ) , and I'm
not sure if this justifies my worries in that I might have contracted
hcv.
Re: should I worry about hepatitis c?
On Sat, 04 Aug 2007 17:25:57 -0700, dacconverter <seagate1556@hotmail . com >
wrote:
>On Aug 4, 6:34 pm, greyhackles <greyhack...@NOSPAMyahoo . com > wrote:
>
>> Of course "it" would be classified as an occupational exposure - assuming you
>> weren't moonlighting at the time ;-)
>>
>
>
>but is this something that I should report to the hospital's
>occupational safety unit?
>
>I may have grabbed onto the sharp end of the suturing needle but I
>didn't necessarily stick myself. I didn't have a visible hole on
>either glove and I didn't bleed or get any skin tears.
>
>I don't know if my experience qualifies as an occupational exposure
>defined by my hospital.
>
>Also, this patient had extraordinarily high liver enzyme volmes
>( would this usually correlate to high hcv viral loads? ) , and I'm
>not sure if this justifies my worries in that I might have contracted
>hcv.
Extraordinarily high liver enzymes do not automatically correlate with high
viral load. One has to consider time, at least: someone chronically infected
for decades with relatively low viral load may well express higher LFTs than
someone with a much higher titre but decades shorter duration. And even that
caveat doesn't explain why there's really no LFT vs VL relationship in the
presence of chronic HCV.
So, you have two issues you're worried about, yes? Obviously, whether you
managed to infect yourself is the big one; but there's also your concern about
how this episode reflects on you in the eyes of the administration, if you
report what happened (and particularly, that you grabbed a suture needle
without using forceps).
So....I see two choices: get tested at another facility (paying cash, of
course), and don't report the event; or, report the event and get tested right
there.
As a technoid-dweeb, I would expect the incident should be reported, if only
to keep system-wide statistics honest. And I think you've scared yourself
enough that you're unlikely to make the same technical mistake again. If you
express your chagrin properly, what's the likelihood there'd be any
ramifications - assuming you're not HCV+ now?
Finally, I rather doubt you did, in fact, infect yourself. But there's only
one good way to find out, and it starts with an HCV antibody test.
I can see how this could be a tough call.
Good luck on all of it.
Certainly hope you're not "virally enhanced" ;-)
/greyhackles
On Sat, 04 Aug 2007 17:25:57 -0700, dacconverter <seagate1556@hotmail . com >
wrote:
>On Aug 4, 6:34 pm, greyhackles <greyhack...@NOSPAMyahoo . com > wrote:
>
>> Of course "it" would be classified as an occupational exposure - assuming you
>> weren't moonlighting at the time ;-)
>>
>
>
>but is this something that I should report to the hospital's
>occupational safety unit?
>
>I may have grabbed onto the sharp end of the suturing needle but I
>didn't necessarily stick myself. I didn't have a visible hole on
>either glove and I didn't bleed or get any skin tears.
>
>I don't know if my experience qualifies as an occupational exposure
>defined by my hospital.
>
>Also, this patient had extraordinarily high liver enzyme volmes
>( would this usually correlate to high hcv viral loads? ) , and I'm
>not sure if this justifies my worries in that I might have contracted
>hcv.
Extraordinarily high liver enzymes do not automatically correlate with high
viral load. One has to consider time, at least: someone chronically infected
for decades with relatively low viral load may well express higher LFTs than
someone with a much higher titre but decades shorter duration. And even that
caveat doesn't explain why there's really no LFT vs VL relationship in the
presence of chronic HCV.
So, you have two issues you're worried about, yes? Obviously, whether you
managed to infect yourself is the big one; but there's also your concern about
how this episode reflects on you in the eyes of the administration, if you
report what happened (and particularly, that you grabbed a suture needle
without using forceps).
So....I see two choices: get tested at another facility (paying cash, of
course), and don't report the event; or, report the event and get tested right
there.
As a technoid-dweeb, I would expect the incident should be reported, if only
to keep system-wide statistics honest. And I think you've scared yourself
enough that you're unlikely to make the same technical mistake again. If you
express your chagrin properly, what's the likelihood there'd be any
ramifications - assuming you're not HCV+ now?
Finally, I rather doubt you did, in fact, infect yourself. But there's only
one good way to find out, and it starts with an HCV antibody test.
I can see how this could be a tough call.
Good luck on all of it.
Certainly hope you're not "virally enhanced" ;-)
/greyhackles
Re: should I worry about hepatitis c?
On Aug 4, 9:19 pm, greyhackles <greyhack...@NOSPAMyahoo . com > wrote:
>
> So, you have two issues you're worried about, yes? Obviously, whether you
> managed to infect yourself is the big one; but there's also your concern about
> how this episode reflects on you in the eyes of the administration, if you
> report what happened (and particularly, that you grabbed a suture needle
> without using forceps).
Occupational exposures are always accidental mishandling, and I'm not
concerned about how I'll be seen by the admin.
But what you think is the likelihood I've been affected with hep c ? I
know that the risk for HIV is even lower but should I worry also about
HIV?
Like I said, I was suturing up a wound without hemostats and manually
touched the sharp end of the suturing needle and passed it from one
part of the wound to another. The wound was bloody at the time and the
patient had elevated liver enzymes. I checked closely for any tears on
my gloves and injuries on my fingers. I didn't find any and I didn't
bleed. But I'm worried that the sharp end of the needle could have
punctured my gloves and pierced the skin of a finger and caused a
little bleeding to the extent where these are not visible to the human
eye.
I was also breathed on alot by the patient.
How much should I worry? And suppose that a healthcare worker actually
does contract HIV or hep c. Would this really put his job on the
line ? ( I don't imagine how it could be since it's difficult for a
patient to get infected from a provider )
by any chance, were you also ever injured on the job?
On Aug 4, 9:19 pm, greyhackles <greyhack...@NOSPAMyahoo . com > wrote:
>
> So, you have two issues you're worried about, yes? Obviously, whether you
> managed to infect yourself is the big one; but there's also your concern about
> how this episode reflects on you in the eyes of the administration, if you
> report what happened (and particularly, that you grabbed a suture needle
> without using forceps).
Occupational exposures are always accidental mishandling, and I'm not
concerned about how I'll be seen by the admin.
But what you think is the likelihood I've been affected with hep c ? I
know that the risk for HIV is even lower but should I worry also about
HIV?
Like I said, I was suturing up a wound without hemostats and manually
touched the sharp end of the suturing needle and passed it from one
part of the wound to another. The wound was bloody at the time and the
patient had elevated liver enzymes. I checked closely for any tears on
my gloves and injuries on my fingers. I didn't find any and I didn't
bleed. But I'm worried that the sharp end of the needle could have
punctured my gloves and pierced the skin of a finger and caused a
little bleeding to the extent where these are not visible to the human
eye.
I was also breathed on alot by the patient.
How much should I worry? And suppose that a healthcare worker actually
does contract HIV or hep c. Would this really put his job on the
line ? ( I don't imagine how it could be since it's difficult for a
patient to get infected from a provider )
by any chance, were you also ever injured on the job?
Re: should I worry about hepatitis c?
On Sun, 05 Aug 2007 08:42:03 -0700, dacconverter
<seagate1556@hotmail . com >, in message ID
<1186328523.968874.129970@b79g2000hse.googlegroups . com >, in the
newsgroup sci.med.diseases.hepatitis wrote:
>On Aug 4, 9:19 pm, greyhackles <greyhack...@NOSPAMyahoo . com > wrote:
>
>
>>
>> So, you have two issues you're worried about, yes? Obviously, whether you
>> managed to infect yourself is the big one; but there's also your concern about
>> how this episode reflects on you in the eyes of the administration, if you
>> report what happened (and particularly, that you grabbed a suture needle
>> without using forceps).
>
>
>Occupational exposures are always accidental mishandling, and I'm not
>concerned about how I'll be seen by the admin.
>
>But what you think is the likelihood I've been affected with hep c ? I
>know that the risk for HIV is even lower but should I worry also about
>HIV?
>
>Like I said, I was suturing up a wound without hemostats and manually
>touched the sharp end of the suturing needle and passed it from one
>part of the wound to another. The wound was bloody at the time and the
>patient had elevated liver enzymes. I checked closely for any tears on
>my gloves and injuries on my fingers. I didn't find any and I didn't
>bleed. But I'm worried that the sharp end of the needle could have
>punctured my gloves and pierced the skin of a finger and caused a
>little bleeding to the extent where these are not visible to the human
>eye.
>
>I was also breathed on alot by the patient.
>
>How much should I worry? And suppose that a healthcare worker actually
>does contract HIV or hep c. Would this really put his job on the
>line ? ( I don't imagine how it could be since it's difficult for a
>patient to get infected from a provider )
>
>by any chance, were you also ever injured on the job?
>
Well I reckon that infection sounds very unlikely but worrying is a
waste of energy when a blood test will give you the answers you need.
On Sun, 05 Aug 2007 08:42:03 -0700, dacconverter
<seagate1556@hotmail . com >, in message ID
<1186328523.968874.129970@b79g2000hse.googlegroups . com >, in the
newsgroup sci.med.diseases.hepatitis wrote:
>On Aug 4, 9:19 pm, greyhackles <greyhack...@NOSPAMyahoo . com > wrote:
>
>
>>
>> So, you have two issues you're worried about, yes? Obviously, whether you
>> managed to infect yourself is the big one; but there's also your concern about
>> how this episode reflects on you in the eyes of the administration, if you
>> report what happened (and particularly, that you grabbed a suture needle
>> without using forceps).
>
>
>Occupational exposures are always accidental mishandling, and I'm not
>concerned about how I'll be seen by the admin.
>
>But what you think is the likelihood I've been affected with hep c ? I
>know that the risk for HIV is even lower but should I worry also about
>HIV?
>
>Like I said, I was suturing up a wound without hemostats and manually
>touched the sharp end of the suturing needle and passed it from one
>part of the wound to another. The wound was bloody at the time and the
>patient had elevated liver enzymes. I checked closely for any tears on
>my gloves and injuries on my fingers. I didn't find any and I didn't
>bleed. But I'm worried that the sharp end of the needle could have
>punctured my gloves and pierced the skin of a finger and caused a
>little bleeding to the extent where these are not visible to the human
>eye.
>
>I was also breathed on alot by the patient.
>
>How much should I worry? And suppose that a healthcare worker actually
>does contract HIV or hep c. Would this really put his job on the
>line ? ( I don't imagine how it could be since it's difficult for a
>patient to get infected from a provider )
>
>by any chance, were you also ever injured on the job?
>
Well I reckon that infection sounds very unlikely but worrying is a
waste of energy when a blood test will give you the answers you need.
Re: should I worry about hepatitis c?
On Sun, 05 Aug 2007 08:42:03 -0700, dacconverter <seagate1556@hotmail . com >
wrote:
>On Aug 4, 9:19 pm, greyhackles <greyhack...@NOSPAMyahoo . com > wrote:
>
>
>>
>> So, you have two issues you're worried about, yes? Obviously, whether you
>> managed to infect yourself is the big one; but there's also your concern about
>> how this episode reflects on you in the eyes of the administration, if you
>> report what happened (and particularly, that you grabbed a suture needle
>> without using forceps).
>
>
>Occupational exposures are always accidental mishandling, and I'm not
>concerned about how I'll be seen by the admin.
Then report the incident and get it off your conscience.
>But what you think is the likelihood I've been affected with hep c ? I
>know that the risk for HIV is even lower but should I worry also about
>HIV?
I've been saying all along I think it's quite unlikely you've been infected.
>Like I said, I was suturing up a wound without hemostats and manually
>touched the sharp end of the suturing needle and passed it from one
>part of the wound to another. The wound was bloody at the time and the
>patient had elevated liver enzymes. I checked closely for any tears on
>my gloves and injuries on my fingers. I didn't find any and I didn't
>bleed. But I'm worried that the sharp end of the needle could have
>punctured my gloves and pierced the skin of a finger and caused a
>little bleeding to the extent where these are not visible to the human
>eye.
>
>I was also breathed on alot by the patient.
Please...As a health care provider, you really should be smarter than this.
>How much should I worry? And suppose that a healthcare worker actually
>does contract HIV or hep c. Would this really put his job on the
>line ? ( I don't imagine how it could be since it's difficult for a
>patient to get infected from a provider )
If your administration took any hostile action against someone infected with
either HCV or HIV on the job, find yourself a good lawyer and sue them under
the federal ADA laws. You'll clean up big time.
As for a patient being infected by a provider: clearly, in the past, at least,
that wasn't all so rare an event. Universal precautions works for both sides
of the patient/provider fence.
>by any chance, were you also ever injured on the job?
Yes, but nothing as "interesting" as your case. I got flattened by a computer
rack that decided to try to take me out...
/greyhackles
On Sun, 05 Aug 2007 08:42:03 -0700, dacconverter <seagate1556@hotmail . com >
wrote:
>On Aug 4, 9:19 pm, greyhackles <greyhack...@NOSPAMyahoo . com > wrote:
>
>
>>
>> So, you have two issues you're worried about, yes? Obviously, whether you
>> managed to infect yourself is the big one; but there's also your concern about
>> how this episode reflects on you in the eyes of the administration, if you
>> report what happened (and particularly, that you grabbed a suture needle
>> without using forceps).
>
>
>Occupational exposures are always accidental mishandling, and I'm not
>concerned about how I'll be seen by the admin.
Then report the incident and get it off your conscience.
>But what you think is the likelihood I've been affected with hep c ? I
>know that the risk for HIV is even lower but should I worry also about
>HIV?
I've been saying all along I think it's quite unlikely you've been infected.
>Like I said, I was suturing up a wound without hemostats and manually
>touched the sharp end of the suturing needle and passed it from one
>part of the wound to another. The wound was bloody at the time and the
>patient had elevated liver enzymes. I checked closely for any tears on
>my gloves and injuries on my fingers. I didn't find any and I didn't
>bleed. But I'm worried that the sharp end of the needle could have
>punctured my gloves and pierced the skin of a finger and caused a
>little bleeding to the extent where these are not visible to the human
>eye.
>
>I was also breathed on alot by the patient.
Please...As a health care provider, you really should be smarter than this.
>How much should I worry? And suppose that a healthcare worker actually
>does contract HIV or hep c. Would this really put his job on the
>line ? ( I don't imagine how it could be since it's difficult for a
>patient to get infected from a provider )
If your administration took any hostile action against someone infected with
either HCV or HIV on the job, find yourself a good lawyer and sue them under
the federal ADA laws. You'll clean up big time.
As for a patient being infected by a provider: clearly, in the past, at least,
that wasn't all so rare an event. Universal precautions works for both sides
of the patient/provider fence.
>by any chance, were you also ever injured on the job?
Yes, but nothing as "interesting" as your case. I got flattened by a computer
rack that decided to try to take me out...
/greyhackles
