Re: How to get needles tested after needle sticks.

From: Dave S (DoggtyredRN_at_earthlink.net)
Date: 06/27/04 

Date: Sun, 27 Jun 2004 21:27:50 GMT

Don Saklad wrote:
> Exactly where would doctors send a needle for testing for infectious organisms
> after a needle stick in cases where the testing could make a difference for
> doctors and their patients?...

There is no conceivable place where a needle would be sent. It does not
contain enough blood to obtain a serum specimen (HIV, hepatitis and
other organisms are sampled from serum, after blood is clotted then
centrifuged). Minimum quantities depending on the lab's equipment ranges
from 1-3cc of serum (which requires anywhere from 2-8cc of whole blood,
a full tube).

>
> What is being asked is not about protocol. What is being asked is
> about where the testing would be done in cases where the test results
> could make a difference to the doctors and their patients.

My answer is not based on protocol. Its based on the limitations of the
equipment in common use today. However, most needlestick protocols and
algorhythms are based upon the same limitations Im basing my answer on.

It is one thing
> for doctors explaining that needles are not tested and would not know
> where to have a needle tested anyway compared with knowing where to send
> a needle for testing for infectious organisms and explaining that in the
> light of knowing where it would not be necessary.

Doctors dont know where they would be sent, because THEY ARE NOT SENT
ANYWHERE. Its just not done. If you have a stick from a positively
identified source, you test the source. That is the industry standard.
If you do NOT have an identifiable source, such as from a sharps box or
a needle left lying around a drug house you simply undergo baseline
testing to determine that you are not ALREADY HIV/Hep positive and then
you make a decision: do I or do I not take prophylaxis. The standard in
unidentifiable contaminated sticks is to offer prophylaxis. Places that
do not offer a "rapid HIV" assay ALSO provide HIV prophylaxis until the
source's lab results are available. Prophylaxis has been documented to
be most effective at preventing seroconversion when started within a few
HOURS (like TWO) of exposure.

EVEN IF there was some commonly available way to test a needle with just
a smear of blood on it, those results would not be quickly available,
and prophylaxis would be offered to the patient pending whatever kind of
result could be obtained. Again, at this point in time, this sort of
testing is not available.

Again, if the source is known or suspected to be infected with a
bloodborne pathogen (or the source is unknown) the routine is to offer
prophylactic meds (which can be given for up to several weeks in the
case of an unknown source).

I'm sure the CDC (or CDCP or whatever their latest name is) can
substantiate what I and everyone else have told you.

Dave
>

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  • Re: How to get needles tested after needle sticks.
    ... >could make a difference to the doctors and their patients. ... >for doctors explaining that needles are not tested and would not know ... >where to have a needle tested anyway compared with knowing where to send ... >light of knowing where it would not be necessary. ...
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