Don Saklad said:Exactly where would doctors send a needle for testing for
infectious organisms after a needle stick in cases where
the testing could make a difference for doctors and their
patients?...
There is no conceivable place where a needle would be sent.
It does not contain enough blood to obtain a serum specimen
(HIV, hepatitis and other organisms are sampled from serum,
after blood is clotted then centrifuged). Minimum
quantities depending on the lab's equipment ranges from 1-
3cc of serum (which requires anywhere from 2-8cc of whole
blood, a full tube).
Quoted message said:
What is being asked is not about protocol. What is being
asked is about where the testing would be done in cases
where the test results could make a difference to the
doctors and their patients.
My answer is not based on protocol. Its based on the
limitations of the equipment in common use today. However,
most needlestick protocols and algorhythms are based upon
the same limitations Im basing my answer on.
It is one thing
Quoted message said:for doctors explaining that needles are not tested and
would not know where to have a needle tested anyway
compared with knowing where to send a needle for testing
for infectious organisms and explaining that in the light
of knowing where it would not be necessary.
Doctors dont know where they would be sent, because THEY ARE
NOT SENT ANYWHERE. Its just not done. If you have a stick
from a positively identified source, you test the source.
That is the industry standard. If you do NOT have an
identifiable source, such as from a sharps box or a needle
left lying around a drug house you simply undergo baseline
testing to determine that you are not ALREADY HIV/Hep
positive and then you make a decision: do I or do I not take
prophylaxis. The standard in unidentifiable contaminated
sticks is to offer prophylaxis. Places that do not offer a
"rapid HIV" assay ALSO provide HIV prophylaxis until the
source's lab results are available. Prophylaxis has been
documented to be most effective at preventing seroconversion
when started within a few HOURS (like TWO) of exposure.
EVEN IF there was some commonly available way to test a
needle with just a smear of blood on it, those results would
not be quickly available, and prophylaxis would be offered
to the patient pending whatever kind of result could be
obtained. Again, at this point in time, this sort of testing
is not available.
Again, if the source is known or suspected to be infected
with a bloodborne pathogen (or the source is unknown) the
routine is to offer prophylactic meds (which can be given
for up to several weeks in the case of an unknown source).
I'm sure the CDC (or CDCP or whatever their latest name is)
can substantiate what I and everyone else have told you.
Dave