Question

You are the RN working in the ER at 2:30AM. Unfortunately it has been a very busy night and the other nurses, PA's and doctors are attending to very seriously ill/injured patients. A young man arrives and appears intoxicated and agitated, barely walking and clutching his right side. Your mind races for split second and you think "appendicitis" or "gall bladder". As you approach him you notice he can't be more than 15 years of age, is wearing name-brand clothing, well-groomed, and generally a nice looking young man. You notice a woman (who appears to be his mother) rushing out of a luxury car and attempting to follow the young man into the ER. As he begins to collapse, you reach for him so as to prevent further injury if he were to actually hit the floor. You assist him to a bed, and prepare to examine and stabilize him. As it appears the drama is coming to an end, you realized you are not wearing gloves and there is a very large scratch on your hand and its bleeding. You tend to your wound, place gloves on your hands, and visit the patient. You are horrified to see that he actually has an open, bleeding wound in his right side, and lacerations on his hands that are also bleeding.

What are the possible questions that need to be asked of the patient for your safety?

What are the possible viral infectious agents that you need to be concerned about for the patient and you?

Explain any/all treatments/supportive therapies with respect to the viral agents that you suspect you are dealing with concerning this patient.

Answer 1

The possible question that has to be asked to the patient for one's safety are

• Does the patient have any infectious disease and on treatment
• Is the patient on any medication,medical condition that can concern to bleed and death
• Has he been vaccinated for Hepatitis B

The possible viral infection to be concerned are

• HIV
• HCV
• Hepatitis B infection

The treatment for any viral infection to be suspected are

• Handwashing by the healthcare professionals in the running water
• Report to the supervisor immediately
• Ensure proper post exposure prophylaxis (the victim is generally administered TT,Antiretroviral drug for 28 days )
• Meanwhile the sample of victim and patient are sent for investigation to identify any infectious agent
• The patients thorough history, physical and laboratory investigations are mist important.

The patient is treated for bleeding immediately and pre bcc ented from shock .Symptomatic treatment with necessary surgical intervention are done.