Introduction: Preparing a patient for surgery
J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan in An Atlas of Gynecologic Oncology, 2018
The risk of acquiring HIV from a single-needlestick injury from an infected patient is in the region of 0.10% to 0.36% (Cardo et al. 1997a,b). Pooled data from several prospective studies of healthcare personnel suggest that the average risk of HIV transmission is approximately 0.3% (95% confidence interval, 0.2−0.5) after a percutaneous exposure to HIV-infected blood and approximately 0.09% (95% confidence interval, 0.006−0.5) after a mucous-membrane exposure (Gerberding 2003). However, using mathematical models to predict lifetime risks of acquiring the infection in a population with a low HIV seroprevalence (0.35%), it has been suggested that 0.26% of surgeons would seroconvert during their working lives (Howard 1990). Needlestick injuries pose a significant occupational risk for surgical trainees. A study by Makary et al. (2007) in The New England Journal of Medicine found that virtually all surgical residents (99%) had had a needlestick injury by their final year of training, and concluded that needlestick injuries are common among surgeons in training and are often not reported. Improved prevention and reporting strategies are needed to increase occupational safety for surgical providers (Makary et al. 2007).
The Safe and Healthy Autopsy
Julian L Burton, Guy Rutty in The Hospital Autopsy, 2010
Sharp objects within the body may alternatively be a consequence of the patient’s lifestyle. Hutchins et al. (2001) reported a series of four patients with seropositive HIV infection who came to autopsy and were found to have retained fragments of needles in the subcutaneous tissues of the neck. Such needle fragments (which were between 10 and 45 mm long) were the legacy of long-term intravenous drug use in patients who resorted to deep cervico-clavicular injection when peripheral access became difficult. These cases were not associated with needlestick injury, but staff performing autopsies on those with a history of intravenous drug use must be aware of this potential (albeit rare) hazard. Radiographic screening has been suggested for cases where retained needle fragments are suspected (Nosher and Seigel, 1993; Hutchins et al., 2001) but this is unlikely to be practicable in all autopsies performed on intravenous drug users. Needle fragments have also been discovered in the myocardium of intravenous drug users (Thorne and Collins, 1998; Burton, 2003).
When things go wrong
Cottrell Elizabeth in The Medical Student’s Survival Guide 2, 2017
Local pain and infection following a needlestick injury are a concern. However, the main concern is whether you have contracted a serious communicable disease from the sharp that has entered your skin. Such diseases mainly include HIV, hepatitis B and hepatitis C. The risk of getting HIV infection from a needlestick injury is <1%.13 The risk of transmission of hepatitis B ranges from 6% to 40% depending on the infectivity of the patient, determined by markers in their blood.14
Dyspnea in homosexual male patients: throwback to an occasionally forgotten but severe clinical presentation of HIV/AIDS
Published in Acta Clinica Belgica, 2020
Koen Verbeke, Roel Verbuyst, Christiane Brands, Hans Slabbynck
A 34-year-old male patient had been sent to the emergency unit by a general practitioner because of progressive dyspnea. His shortness of breath was mostly exertional. There was no important medical history. The patient was a wine merchant and had recently made an eight hour drive. He had a male partner. The GP had already tried a beclomethasone/formoterol inhaler without any result. On clinical examination, we saw a patient in moderately respiratory distress (inability to speak whole sentences). Lung auscultation was normal, there were no cardiac murmurs or edema. He didn’t display fever, important cough or sputum production. Lab results were normal in exception of an elevated D-dimer (0,64mcg/mL), C-reactive protein 50,8 mg/L and Lactate dehydrogenase (2098U/L). Oxygen saturation on the emergency unit was 94%. An X ray of the chest didn’t show pneumonia, pleural effusion or congestion. The arterial puncture was unsuccessful and even resulted in an accidental needlestick injury to a medical trainee on the emergency unit. The emergency doctor thought of a viral bronchitis and prescribed an extra short acting bronchodilator. If the dyspnea worsened, the patient got the advice to come back to the emergency unit for a CT scan to rule out pulmonary embolism.
How Integrated Anesthesia Communication Leads to Dependable IONM Data
Published in The Neurodiagnostic Journal, 2021
Veronica O. Busso, John J. McAuliffe
On the heels of this culture change, multiple providers were experiencing IONM needle sticks either during patient positioning or during the loss of an IV or an arterial line. Several additional strategies were implemented to decrease these events. The development of an IONM time out prior to patient positioning. The IONM technician reviews the areas of IONM needle placement with all parties participating in patient positioning. In addition, the IONM technician will remove the electrodes from the patient’s head prior to positioning. Once the occurrence of needlestick injury decreased from the positioning of the patient we continued to have rare instances of reports. Upon further investigation, the trend for these injuries was related to the loss of an IV or arterial line typically in the hands. Upon removal of the dressing, an IONM electrode would often be dislodged and the provider attempting to replace the IV or arterial line would be injured. If the team loses access after positioning, the IONM technician will first remove the electrodes in the adjacent area prior to the anesthesia or nursing team taking down a dressing and attempting access again.
Hepatitis-C Virus Infection and Exposure to Blood and Body Fluids among Nurses and Paramedical Personnel at the Alexandria University Hospitals, Egypt
Published in Alexandria Journal of Medicine, 2018
Yehia Abdelghaffar Moustafa Seida, Maha Mohamed Helmy Moemen, Mona Shawki Ali Moustafa, May Moheb Eldin Mohamed Raouf, Noha Selim Mohamed Elshaer
In the current study, relatively high incidence of accidental NSSIs (44.7%; with13.5% of the injured HCWs reported ≥5 injuries) and BBF exposures (38.2%; with 45.5% had ≥5 exposures) was found among studied HCWs during the last 6 months. The findings of the current research are consistent with the results of another study conducted among HCWs in operating rooms at the Alexandria Main University hospital, where 61.3% of HCWs experienced sharp injury (24.6% of them had ≥5 injuries), and 66.7% of HCWs experienced BBF exposures (47.1% of them had ≥5 exposures).30 In addition, Hanafi MI et al., 2011 study reported that 67.9% of HCWs had at least 1 needlestick injury in the previous 12 months with 5% experienced more than 3 injuries.31 However, lower prevalence of sharp injuries among HCWs was reported in Kenya (19%).32 Yousafzai et al., 2013 found 26.7% of practitioners in private medical clinics had at least 1 sharp injury in the last 6 months.33
Related Knowledge Centers
- Hepatitis B
- Hepatitis B Virus
- Hepatitis C
- Hypodermic Needle
- Mucous Membrane
- Prion
- Seroconversion
- Blood-Borne Disease
- HIV
- HIV/AIDS