Question

Victor Krenz is assisting Dr. Connors with the fifth cataract surgery for the day. The patient is Kathy Wall, a diabetic patient, whose condition has been stable enough for her to undergo a surgical procedure. Victor has performed a six-minute surgical scrub on his hands before each of the five procedures. Dr. Connors indicates that he is in a hurry to get back to his office for a heavy afternoon schedule of patients. After both Dr. Connors and Victor are scrubbed, gowned, and ready to begin the operation, Victor feels a slight prick on the tip of his gloved finger as he moves the sterile syringe and needle on the tray. Dr. Connors, who does not notice the accidental needlestick to Victor’s glove, states again that he is in a hurry to finish this procedure. Victor knows that it will delay the surgery if he has to change gloves. He also knows that his hands have had a surgical scrub five times that morning and that they are clean. Provide detailed answers for each of the following questions. Your response should be one-half (1/2) page in length.

Can Victor justify not changing into new gloves?

What could happen to Ms. Wall as a result of Victor’s needlestick?

How should Victor handle this situation?

Answer 1

Can Victor justify not changing into new gloves?

Answer: No,

Rational: first of all cataract surgery requires sterile filed, victor's hands considered cleaned not sterile even after scrub, when he wore so that it is not advised to continue to assist the cataract surgery after found to have needle stick injuries due risk of blood borne pathogens.

What could happen to Ms. Wall as a result of Victor’s needle stick?

Answer: Possible transmission of blood born disease such as Hepatitis B and HIV from Victor's blood if he has any.

How should Victor handle this situation?

1. Immediately dispose the needle into puncture proof container.

2. Wash the hands under running water, encourage bleeding and wash with soap and water.

3. Inform the Dr. Connors that he had needle stick injury and report to emergency to do screening and follow post exposure prophylaxis as per hospital protocol. Viral Screening includes HIV, hepatitis B and C.

Treatment include antibiotics or hepatitis vaccine.

Note: since the incident happens before starting the surgery it is advised to do viral screening only the victims.