Page 1 of 1: Needle Stick Counselling

Kai1111 · Credits: 2036 My Scrapbook

From a test bank:

Counsel a patient who had a needle stick injury from a blood stained needle in a park.

I'd approach this with a reassurance to the patient that although there is some risk,it all probablyt isn't real high because the injury involved a very small volume of blood, if any....i.e. if she isn't involved in high risk behavior, the volume of blood contamination is likely very low.

The needle should be examined and the gauge size noted; fresh or dried blood noted. The depth of the needle stick should be estimated. Clean the wound; irrigate copiously.

Nevertheless, we should draw her serology for HIV and hepatitis C and B (if not immune). tetanus immunization

If the depth of wound is deep and needle guage high, prophylaxis for HIV would be advised.

If the needle stick is considered low-risk, repeat HIV levels at 6wk, 12wk and 6mos...and prophylaxis offered ZDV 200mg 3X/d & 3TC 150mg 2X/d all for 4wks.

Any other thoughts?

bush5 · Credits: 1111 My Scrapbook

describe what happende
was it a hollow bore needle?
do you know the gauge of needle?
what was the color of needle?
How for did it penetrate?
Did it contain blood from the person?
Was the blood injected?
Do you know whose needle was this?
Do you know HIV and hepatitis status of that person( if person i s known)
ask about sexual history? No. of partners? use of condoms
asl about needle sharing? IV drug abuse
any tattoo marks on body
any blood transfusions or surgeries in the past?
ask about the mood, homicidal and suicidal ideations
be empathetic
ask about vaccinations?

Counselling? ask will do the HIV test( with the consent), HBsAg testing
tell the patient risk of HIV transmission is very very low only 0.3% and hepatiits B risk is much greater >40% and hepatitis c is only 5%.
explain the window period?

if test results come back positive will inform the pulbic health?

safe sex till that period

dont share needles

Ask about support system

tell that everything should be kept confidential till that ime
can start medications

offer pamphelets and hotline numbers

provide ongoing support

Kai1111 · Credits: 2036 My Scrapbook

You rock! I am really impressed with your knowlege and thought processing....lucid and clear....many thanks!

QCDOC · Credits: 460 My Scrapbook

do we have toadvise that the patinet should tell her parner right away or wait for the results to come...

What's the answer??/and window period how to explain it in layman language

Thanks

Kai1111 · Credits: 2036 My Scrapbook

I feel the partner has a right to know and should know what happened. Safe sex is advised until all the results come back neg.....that means, at least 6 mos if one doesn't know to whom the needle belongs.

voxel · Credits: 32271 My Scrapbook

I think we need to ask about the tetanus immunization as well.

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