Question

Case Study: Larry is certified surgical technologist working in the general surgery unit of an urban hospital. He and Dr. Hobart are finishing a case where a known IV drug user suffered a gunshot wound to the abdomen. While Larry was counting instruments with the circulator, Dr. Hobart tossed a loaded needle holder back onto the mayo stand without informing Larry. As he turned around, the bloody needle penetrated Larry's single glove and punctured his skin. Larry immediately reported the needle stick injury to the circulator, who removed his glove and helped him assess the wound while paging for a replacement CST. After being relieved at the field, Larry washed the wound with soap and water. Because occupational health was closed at this hour. Larry reported to emergency department for treatment, and then field all appropriate reports.

                          Questions

Q1. What should Larry do with the needle and needle holder after they became contaminated with his blood?

Q2. Did Larry handle this incident correctly?

Q3. What should Larry have done to possibly protect himself from this injury occurring at all?

Please this is a surgical technologist question but I don't have the option to choose, so chose nursing. (Subject: Surgical technologist course)

Answer 1

ANSWER

1 The needle should be carefully discarded in the puncture proof sharp container. The needle holder should rinse under warm water running water to remove all blood. Then perform cleaning either by ultrasonic cleaning or manual cleaning method. Then let it dry in a clean environment and sent for autoclaving after lubricating.

2 The action of Larry couldnot be appreciated fully because immediately after had a needle stick injury he should wash the wound immediately with soap and water. But in this case he waited till completing the replacemnt activity for CST and there is no need to waste time for assessing the wound. IEventhough occupational health is closed its a good thing to report in the ED. He should report it tothe supervisor also.

3 Double gloving reduces the risk of exposureas much as 87% when outer gloveis punctured.

Use of blunt tip suture reduce needle stick injury.

Creating neutral zone, which is a designated area where sharp only may be placed and retrieved. If the sharps is mixed with other instrument , chances of injury is high

Instruct the surgens announce loudly while returning instrument to the stand or to the scrub tech. Hand to hand pass should be done carefully. Avoid tossing of sharps.