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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31584
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I am an experienced RN and educator. My specialty is

Customer Question

Hi, I am an experienced RN and educator. My specialty is psychiatric disorders and behavioral health. I work at a large Magnet recognized hospital.
7 days ago when I was administering lovenox I stuck myself. The lovenox does not have a retractable, or push cap in place.
I was in an isolation room. Patient, acute psychosis, Axix 1 Schizophrenia, Axis 2 deferred, Axis 3 VRE (septic) in blood. MRSA active, nares, peri, blood, ESBL blood.
I injected into the the fatty subcutaneous tissue of the abdomen. Then I steadied my forearm on a flat surface to recap.
The needle pierced the cap, my glove and my finger.
Upon removal of my glove, I was bleeding. This is my first needle stick injury. But I didn't make a report. I acquired from the chart, patient is HIV negative, RPR negative, Hep C negative.
The last 3 days my symptoms are, general malaise, low back pain, joint pain, SOB, tachycardia, nausea and foul smelling, and frequent painful bowel movements. Not normal for me.
Could I have introduced into my blood the MDROs, in her blood?
JA: Have you had any recent injuries? What seems to make the pain better or worse?
Customer: No recent injuries, aside from the needle stick injury. Nothing makes the pain better or worse. I am progressively more ill each day.
JA: Anything else in your medical history you think the doctor should know?
Customer: I am low in Vitamin D, this has been a long term issue. Thyroid normal, ANA, investigated several years ago...But cleared by endocrinologist, idiopathic hyperprolactemia. I am not on any antipsychotic medication and my MRI w/w o was negative for pituitary tumor. I have never been sick. I was raised by parents who did not allow the use of antibiotics. I think I had one course of antibiotics in my life, I am 43. I don't catch colds or flu and I have had emesis from my daughter enter my mouth when she had strept throat. I never was infected. I breast fed and maintain an organic diet, no GMOs, hormones, antibiotics or pesticides. I have always been healthy. But I am quite ill and would like to know, perhaps the needle stick injury has introduced into my blood the cause of my present condition?
Submitted: 3 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 3 months ago.

Hello,
I am Dr. Arun and will be helping you today.

You are experienced nurse; so let me at the outset tell you what you already know. There is a definite possibility of infective organisms going in your blood stream with the needle stick injury. I would emphasize following points;

1) I hope you are not anxious. So that may augment your symptoms as it involves the autonomic nervous system and can aggravate the clinical picture.

2) With your knowledge and experience; one should have reported the needle stick injury to the administration. They would have done a blood culture and an antibiogram immediately. But do not delay now. This needs immediate attention of the doctors. Let us rectify it at the earliest.

3) I still feel that some of your symptoms can be due to anxiety. But since the symptoms are deteriorating, and infections are quite uncommon for you; you cannot take a chance.

4) Lastly; there is a risk of transmission of the bacteria by the needle stick injury. But there is a significant chance that bacteria may have not been transmitted and the present symptoms are unrelated to the needle stick. This maybe a just a co-incidence that you got these manifestations after the incidence and is an unrelated infection.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 2 months ago.

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