Needless needles

A guy came in today with a minor facial laceration. I was sent in to stitch him up and I thought my biggest worry would be if I could keep everything that needed to be sterile sterile.

I was in a little bit of a rush cause I'd been slowed down previously by another patient's overbearing wife, and I didn't want to keep my preceptor waiting. I hastily grabbed the suture to load it into the needle driver when I felt something sharp go deep into my thumb.

Fuck.

I yanked my hand back and looked at it intently. Luckily, my patient's head was covered with the surgical drape so he couldn't see what was going on. I didn't see any puncture on the glove so I kept on working, but the thought of a needlestick infection was niggling me until I sewed shut his injury. It felt like it went in pretty deep though... No blood from my thumb but it was a pretty fine blade to begin with.

The worst part about this was I didn't do anything about it. I didn't tell anyone cause I thought it wasn't a big deal and that nothing would come of it. The patient got his tetanus shot and left, and by then I'd started wondering if I shouldn't have taken a more thorough medical history. All these shortcuts I take in emergency seem to come back to haunt me...

He didn't seem like a high risk individual, but god dammit. Who knows who's really high risk and who isn't? The stupidest thing for me to do was wait and not do anything about it or tell anybody about it. I studied my thumb intently. Still no blood and still no sign of puncture. Does that mean I didn't get stuck? Couldn't a virus stil be transmitted subcutaneously? I was so terrified of having contracted something evil I filed it under F for Forget About It and saw some more patients. It's probably nothing, I thought.

But every second that ticked by made me feel stupider and stupider for not having said something a second ago, but I felt like if I said something now I'd seem even stupider for not having said something earlier. I knew I was being an idiot but I couldn't help myself. I should have stayed in bed today.

I googled needlesticks and looked at the stats. 1 out of 300 needlesticks with HIV positive patients will cause an infection. Good odds, I supposed. I didn't even know if this guy was HIV positive or not. Hep B I've been immunized for. Hep A, whatever. I can deal with Hep A. Hep C though...

I looked at my thumb again, and squeezed it, checking it under a bright light for any sign of trauma. I knew I wouldn't see anything, and even if I did what did I expect to find? It's not like the virus is going to let me know I'm there. Until my liver dies or I get AIDS.

Now I was starting to get worried. Partly cause I had been exposed, and partly cause I couldn't stop acting like an idiot and just tell someone I'd been stuck. Why couldn't I just suck it up, look like a moron and get some help?

I ended up talking to my preceptor about it in the end, and he said to call the patient and ask about risk factors and leave it at that. I called and nobody was home. While I was waiting, my preceptor told me about the time he got a needlestick while working on a guy who had recieved multiple transfusions. Nothing happened to my preceptor in the end, which is nice. But what about me?

Still waiting for the guy to get home. Good lord I hope I'm worrying about nothing.