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Contaminated needle

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Hello, I am a nurse and have a question about infection control. Yesterday at work I had a patient who was confused/erratic and she moved her arm just as I was about to inject insulin. The tip of the needle touched my skin before I gave the injection. It didn't puncture my skin or get any of my blood on it but it could have transferred whatever was on my skin into the patient. Is there a chance the patient could get an infection? Do I need to notify her MD? It was a subcutaneous injection if that helps, and the patient was admitted for altered mental status stemming from liver failure due to alcohol abuse. Thanks for your help!

Category: Infectious Disease Specialist

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Category: HIV- AIDS Specialist
 30 Doctors Online

Hello, thankyou for approaching DoctorSpring with your query.
My advise to you would be to inform the patients MD. As the patient is a diabetic patient she is prone for infection. In addition she is already in a compromised state where her immunity is lowered even further.
Any contaminant that could have been transferred onto the needle can inoculate in the patient subcutaneously and result in an abscess. By informing the MD it will be easier to for him to take precautionary measures in treating the patient.
Even if you would have followed the guidelines and washed your hands thoroughly and used an alcohol based hand disinfectant before administering the injection, there are still chances of contamination being there.
And hence I would say inform the MD.
I hope this has helped you. For an futher queries please feel free to follow up.
Thankyou


Patient replied :

Thank you! Is there anything the MD can do to prevent an abscess? Also, how quickly would that develop? Thanks for your help!


Hello,

Thank you for the followup. I discussed this scenario during our routine case discussion. Interestingly most of our Doctors think that there is not much risk. Even though this is contradicting my first answer, I though I should mention this here.
Unless you are HIV, Hepatitis B or C positive or have an active infection in the part of your body where the needle touched, the risk is only "technical" and no need to worry about this.

Notifying the MD would be optional ( * mandatory if you have HIV, Hep B or C) positivity ). Even if you inform this to there MD no actionable plans can be taken, other than observation. This will only add to confusion. And these incidents are not rare in patients who are taking self injections/daily injections. But most of the times there is no additional risk.

I do understand this reply is contradicting my first reply. Apologies for that. While my first reply is a text book reply, this is more practical and collective opinion.

Hope this helps
Feel free to ask followups
Thank you

Dr.DSS
Dr.SM
Dr.VV


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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