Need Help With A Needlestick

[MedicAR]

I've been away for awhile, but still in EMS. For those that may recall, I am less than happy with my employer and here's another shining example of why.

Yesterday morning I was checking my jump kit on the rig and when I went to pick up an item, I felt a poke in my finger. I pulled it back to find a tiny puncture mark in it that was bleeding. There was an open, uncapped blunt needle in the tray. I immediately went to our Infection Control Officer and began the paperwork, after giving the puncture several good squeezes and washing and disinfecting my hands. The ICO went to the Captain on duty who deterined without even laying eyes on me or the needle that this was "not an exposure" and that nothing needs to be done. The ICO has fought this to the highest possible level at this point, making the case that the ICO has the ultimate authority here, not a Captain on duty or even our Chief. However, the brass is saying that the captain was right, again without even seeing me or the needle in question, and to do nothing. To make matters worse, the Captain disposed of the needle! There is nothing to double check now!

Rationally, I know that the likeliehood of actually catching anything from this is low. A blunt needle shouldn't be used on a person or to transfer blood into approved containers. However, it also shouldn't be left open and then covered in a jump kit either. And given the quality of people we have and the level of general intelligence there, there is no way to be certain that this didn't contain potentially infectious materials.

I just want to cover my butt. I'm not out to get anyone, but I don't want to catch any diseases either.

Any advice is welcome!

[VentMedic]

1. Does this company not have a written policy in place?

2. What state are you in and does it not have a statute or law that governs this for which the agencies base their policies from?

[MedicAR]

1. Does this company not have a written policy in place?

2. What state are you in and does it not have a statute or law that governs this for which the agencies base their policies from?

The current policy is unclear at best. The pending policy is the one that I had a hand in writing, it was written in September and has only recently begun to be reviewed by the powers that be. It is 100% clear and states that I must have baseline bloodwork performed.

I'm in Arkansas and am wading through state statutes and guidelines. It was difficult to find anything definititve while writing the policy, so I used the most stringent ideas I could in order to cover us as much as possible, generally taking everything to the federal level and using CGC guidelines where ever I could. I had help from some members here, as this was my first effort at writing policy, plus I'm a nobody.....a street medic, not an officer of any kind.

[FireMedic65]

I would def go to the hospital and get checked if you haven't already.

Contact your state DOH and discuss it with them since they would be more knowledgeable on the laws of this.

If your boss is going to be a dick about it, you can too. Get a lawyer if need be.

[MedicAR]

I would def go to the hospital and get checked if you haven't already.

Contact your state DOH and discuss it with them since they would be more knowledgeable on the laws of this.

If your boss is going to be a dick about it, you can too. Get a lawyer if need be.

All right, so I'm not jumping the gun. I've got call into the DOH already and left messages for our medical director.

I really don't want a fight, I just want to be covered if anything should happen down the line.

[UMSTUDENT]

Get a lawyer. Now.

I've had an exposure before and I know how worrying it can be. Time is of the essence in these types of events. Even if the possibility of transmission if low, employers are bound by most state's Occupational Health Service/Departments to provide an adequate infection control policy. Your safety is top priority!

At the very least make sure your objections are well documented so you have recourse if something happens. You'll be able to show that your infection was caused at work and hopefully get worker's compensation to pay for any future care.

[chaser]

...The ICO went to the Captain on duty who determined without even laying eyes on me or the needle that this was "not an exposure" and that nothing needs to be done. The ICO has fought this to the highest possible level at this point, making the case that the ICO has the ultimate authority here, not a Captain on duty or even our Chief. However, the brass is saying that the captain was right, again without even seeing me or the needle in question, and to do nothing. To make matters worse, the Captain disposed of the needle! There is nothing to double check now!...

I agree with getting all your documentation in order. To brush you off and sweep everything under the carpet is just wrong.

There should be written protocols for needle exposure, or anything else for that matter. Where is OSHA in all this?

You most likely will be fine, but if not, then what? What about the next person this happens to, or for that matter, how many times has this happened before?

I would go after their asses.

[VentMedic]

There should be written protocols for needle exposure, or anything else for that matter. Where is OSHA in all this?

That was my initial thought also. Does this service not offer any type of OSHA blood pathogen training or is this not required by your state for certification or recertification? What about all the other infection control aspects of the job and disease exposure accountability?

Exactly what is the purpose of the Infection Control Officer if he does not know the P&P to initiate advisement, testing and treatment options as required within your state or local laws? The clock is ticking on your options if you so choose to follow through.

Edited May 14, 2009 by VentMedic

[Dustdevil]

Wow. Just... wow.

Definitely go to the county health department to report the exposure and get baseline testing. They will most likely take it from there, but assure that this gets to OSHA. I smell a fine and possibly state sanctions against this employer.

But wtf is a "blunt" needle anyhow?

[MedicAR]

But wtf is a "blunt" needle anyhow?

I don't know why, but I really hoped you woud chime in on this one. Thanks for the advice!

As for a blunt, it a large bore needle generally used for drawing up meds that's not as sharp as a general needle. Ours also happen to be filtered, but there are just blunts. My concern is that since there were no blood transfer devices in the jump kit that this needle may have been used to transfer blood from a syringe to the tubes. When backtracking with other medics, none of them recall having such a needle out.