Needlesticks and HIV testing

[Stitch]

I wondered how people would handle this situation. It happened on someone else's shift, but it got me thinking.

The other night one of the residents stuck himself pretty good while suturing. Our state does have laws requiring HIV and hepatitis testing after a needlestick injury, but the family adamantly refused to allow their kid to have blood drawn. They basically stormed out (threatening to sue us, ironically). How do you enforce something like that? The resident is understandably upset and their refusal raised a red flag. We all agree that the risk of transmission is low, but having a negative test would make him (and anyone in that situation) feel a lot better.

What are the options and how would you handle it? Let them walk out? Call a judge and get a court order? Involve the police after they are gone?

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[Rendar5]

I wondered how people would handle this situation. It happened on someone else's shift, but it got me thinking.

The other night one of the residents stuck himself pretty good while suturing. Our state does have laws requiring HIV and hepatitis testing after a needlestick injury, but the family adamantly refused to allow their kid to have blood drawn. They basically stormed out (threatening to sue us, ironically). How do you enforce something like that? The resident is understandably upset and their refusal raised a red flag. We all agree that the risk of transmission is low, but having a negative test would make him (and anyone in that situation) feel a lot better.

What are the options and how would you handle it? Let them walk out? Call a judge and get a court order? Involve the police after they are gone?

I guess it really depends on the laws of the area. Is there any blood in the lab still on which you can add tests? In my state, you can do this no problem for Hepatitis, but can't do it at all for HIV because it's stupidly a separate form (don't get me started on the continued existance of separate opt-in testing for only one disease). So they would've just started HAART the day of the needlestick, and tested in a month or something like that. Unfortunately nothing afaik could be given as Hep prophylaxis. And the patient would've been allowed to refuse testing.

 

[willow18]

There is/was a movement in some states to allow for automatic testing in these cases. The lawyers/legislators are understandably blocking it because then they can go and say to the sheep that they "protected their privacy". I think there is a national movment to take off the stigma that law has attached to the HIV test with the stupid counseling and s#$t that is required. But yeah, otherwise there's nothing you can do. Part of the job.

Oh, and apparently "AIDS activists" are happy to propagate this stigma.
http://www.gaycitynews.com/site/news.cfm?newsid=20317086&BRD=2729&PAG=461&dept_id=568864&rfi=6

I love this sentence from this article:

Among all men, the new infection rate went from 0.72 percent in the second half of 2000 to 0.44 percent in second half of 2004. During that time, the rate among heterosexuals went from 0.29 to 0.08, the rate among women went from 0.32 percent to 0.06, and the rate among drug injectors went from 2.54 percent to 1.04 percent. Those declines were statistically significant.

While those declines cannot be attributed entirely to Frieden policies, they certainly made a contribution. But, he has consistently failed in reducing new HIV infections among gay and bisexual men.

What did you expect him to do? Go around looking for MSM's and stick condoms on them? wtf

 

[pseudoknot]

We have automatic testing in Virginia, but I doubt it extends to being able to hold down the patient and draw blood against his will.

 

[Stitch]

We have automatic testing in Virginia, but I doubt it extends to being able to hold down the patient and draw blood against his will.

That's where I am. It actually worked out that the ID department called us and had the police go out to the house and tell the family they had to come back for testing. I don't know what would have happened, if the family had refused, but they didn't and it worked out. One of the ID guys said you could get a court order, but again, how do you force someone to give up blood?

 

[pseudoknot]

That's where I am. It actually worked out that the ID department called us and had the police go out to the house and tell the family they had to come back for testing. I don't know what would have happened, if the family had refused, but they didn't and it worked out. One of the ID guys said you could get a court order, but again, how do you force someone to give up blood?

Well, if you had a court order, I suppose there's always brutane...

Can you draw blood for HIV testing through an IO?

 

[SoCuteMD]

Well, if you had a court order, I suppose there's always brutane...

Can you draw blood for HIV testing through an IO?

If held in contempt for ignoring court order, the punishment is jail. That usually encourages compliance