Injured by acupuncture, patients conceal STDs, medical staff commit suicide! 13 million medical staff are at risk of infection, NEJM has a bright view!

內容目錄

Medical staff was injured by needle sticks, patient concealed history of syphilis ,

Casual disaster

< span>On August 4th, a tragedy suddenly broke out on the Internet.

When a 21-year-old medical staff inserted a needle into a patient, the patient raised his hand to answer the phone, but unexpectedly stabbed the needle into the patient. on the hands of medical staff.

Source Weibo:

‘s back garden p>After the incident, for some unknown reason,the patient only disclosed that he had hepatitis B, but did not tell the hospital and the client that he had syphilis.

When the patient’s test results came out, the test list for hepatitis B and syphilis double-positive appeared in front of his eyes, completely defeating the careless medical staff.

Afterwards, her life suddenly fell into a black abyss:

After her career was exposed, she ushered in a face-to-face The director, superiors, and head nurse blamed her for being careless and careful;

My boyfriend broke up with her ruthlessly after learning that her occupation was exposed;

The roommate separated from her tableware after she knew the truth about her occupation;

After taking the medicine, she had various discomforts Symptoms;

The pain of being infected is always worrying, making her sleepless every night;

img>Source Weibo: Net Reds’ Back Garden

The medical staff shared his fear, anxiety and disappointment on social networks , she said:After occupational exposure, I don’t know what will happen in the future, and I don’t know if I will be infected. This kind of fear is always hanging, and I can’t see any sunshine. Every second of my life is a torment.

She is really desperate, and the various encounters after her occupational exposure are undoubtedly aggravating and become the last straw that crushes her.

Source Weibo: Net Reds’ Back Garden

month

On the 2nd, the young medical staff chose to commit suicide after taking medicines for a month at a time.Eventually caused gastric bleeding and multiple organ failure, and unfortunately passed away at 20:00 on August 3rd.

Seeing such news, we only feel sorry and sad, this tragedy could have been avoided.

If the patient informs the medical history in time and does not deliberately hide it…

If the hospital leadership does not blame her, but instead Consolation and encouragement…

If her boyfriend and classmate were not so ruthless, give her more care…

If the hospital’s psychological construction department spent more energy to help this medical staff…

It’s a pity , There is no if in reality, this medical worker who is in his youth will not be able to come back after all.

Health care workers have occupational exposure risks throughout their medical career,

The situation in our country is extremely serious!

There is no doubt that we, as medical workers, almost all encounter occupational exposure in our medical career. . Who can guarantee that you will never be scratched by sharp tools such as needles and scalpels in your life?

And occupational exposure is more than just sharp weapon injuries.

As defined by the British Encyclopedia, medical staff occupational exposure refers toa type of occupational exposure in which medical personnel come into contact with toxic and harmful substances or infectious pathogens in the process of diagnosis, treatment and nursing activities, thereby damaging health and even life-threatening. According to the common standards of academic research, it can be divided into infectious occupational exposure, radioactive occupationexposure, chemical occupational exposure, and other occupational exposures.

medical careoccupational exposure is almost impossible to prevent, it exists in your work. It consists of three parts:

1. Sharps scratches:Items that can pierce the skin, common sharps include span>Injection needles, puncture needles, suture needles, blood collection needles, glass slides, broken ampoules, etc., that is to say, in common nursing situations such as surgery and infusion, medical staff Potential for skin puncture and occupational exposure.

2. Mucosal Contact:Inside the nose, Inside the eyelids, inside the mouth, respiratory tract, digestive tract, sexual organs, etc. Occupational exposure may occur if the patient’s body fluids come into contact with the mucous membranes above the medical staff.

3.HBV (hepatitis B virus), syphilis, HCV (hepatitis C virus), HIV (AIDS virus) can all be transmitted vertically through blood, body fluids and mother-to-child transmission, And it carries the virus for life. Once exposed, it is highly infectious.

In 2016, researchers from 15 hospitals including Shandong University Affiliated Provincial Hospital and Central South University Xiangya Hospital took the form of distributing questionnaires to 158 hospitals in 13 provinces across the country. Medical staff in different levels of hospitals have conducted surveys on occupational exposure and occupational exposure management, and published “Investigation and Analysis on Occupational Exposure and Protection of Chinese Medical Staff”< span>.

The research results show that the departments and operating rooms with higher probability of occupational exposure are , Intensive Care Units, Dentistry and Emergency Departments.

This shows that even in the context of daily care, medical staff cannot take it lightly.

In this report, as many as 122 hospitals have occupational exposure of medical staff, accounting for 77.22% .

According to the World Health Organization, there are approximately 3.4 million every year in the world. >Health workers are exposed to blood or body fluids due to needle sticks or sharps, and the figure in China is about 300,000; Among them, 37.6% had hepatitis B, 39% had hepatitis C, and 4.4% had AIDS, all of which were caused by needle stick injuries.

In general, compared with the rest of the world, medical workers in my country face a greater risk of occupational exposure, serious harm, and a grim situation.

In addition, compared with the physical harm, once the medical staff is exposed to occupational exposure, the psychological harm should not be underestimated.

Some researchers used 118 medical staff with blood-borne occupational exposure from January 2017 to December 2018 in 3 hospitals in Shandong Province as samples to conduct medical treatment. A survey of personnel occupational exposure and mental health.

The results of the survey show that after blood-borne occupational exposures of medical staff, are highly prone to depression, anxiety, paranoia Post-traumatic stress disorder (PTSD) is very common. Different coping styles and different social supports after occupational exposure are factors that affect the mental health of medical staff.

It is not difficult to understand why the 21-year-old medical staff chose to commit suicide after the recent occupational exposure.

Unfortunately, depression, anxiety, fear, paranoia, and post-traumatic stress disorder are inevitable, but the people around her have given her due care and comfort Yet?

None of them, whether it was leaders, classmates, relatives or boyfriends, they all treated her with indifference and “abandoned” her severely.

Whose fault is this?

Who is the patron saint of medical workers seeking help on the online platform?

Xiamen is one step ahead, and Mace is willing to do it too!

The case of a suicidal female doctor above is not an isolated case.

For new doctors and nurses, it may be just a needle stick, a sharp incision, or Blood splattered on the body, but such encounters are almost commonplace, and not every case of occupational exposure will be fully registered and reported.

On Internet platforms such as Zhihu, Tieba, and Metz Medicine, we can see that many doctors who are experiencing occupational exposure come to seek help. Frightened, anxious, helpless, sad and helpless, although I know that there may not be much hope for help, I still share my pain with millions of netizens, hoping to get help and understanding from others.

There are some doctorsLeave us a message and ask us for help in pain.

Doctor 1: I was stabbed by a needle from Da Sanyang. Because I was not familiar with the procedure, I used my own medical insurance The globulin hit by the card, the hospital will not reimburse me because there is no invoice, what should I do?

Doctor 2: I recently saw a weak HIV-positive elderly man who is 76 years old. He was positive, put him in a stomach tube, spit me all over his face, and got fluid in his eyes. I am so scared now that I have already taken blocking medicine, because of the fear, I always have insomnia and a splitting headache!

Netizen 3: I really love myself. I work as a midwifery in a township health center at the lowest level. Know how many times you’ve been pricked by a needle! I don’t know how much amniotic fluid I drank from mouth-to-mouth suction! Fortunately, there seems to be very little HIV and syphilis in that era! However, I have not been vaccinated against hepatitis B, but the surface antibody is positive, which must be the result of occupational exposure.

Netizen 4:Last week, I was pricked by the core of a syphilis patient’s indwelling needle and had been injected twice Benzathine penicillin… I’m still in fear, God must bless me.

We can’t help but ask, who will take care of the occupational exposure of medical staff?

Picture Source Network

Hospital infection management department is in charge, and a few hospitals are in charge of preventive health care department or medical department.

The unclear powers and responsibilities of the occupational exposure management department, imperfect occupational exposure rules and regulations, and outstanding occupational exposure underreporting are all problems that need to be solved urgently in the occupational exposure management of medical staff. .

In addition, the cumbersome registration process, the lack of news after reporting, and the difficult and long journey to claim compensation may all be the reasons why the medical staff swallowed the bitter water.

So, in reality, the group of medical staff who have experienced occupational exposure will only be more than imagined.

As the world’s most populous country, my country’s demand for medical care has surged. From January to April 2022 alone, the number of visits to medical and health institutions across the country has reached 2.08 billion visits.

This also means that the work pressure of medical staff is further increased. Health care workers are at increased risk of exposure to blood-borne pathogens as the number of visits increases.

Screenshot of the Health Commission

There is no specific national protection and compensation policy for personnel occupational exposure, which is really worrying! In this regard, we might as well study Xiamen.

A few years ago, the Xiamen Municipal Health and Health Department took the lead in organizing the drafting“Occupational Safety Protection Regulations for Medical Staff in Xiamen Special Economic Zone” (tentative name) The draft legislative proposal has been included in the 2021 Xiamen Legislative Plan Alternative Projects, which means that the relevant legislative work has been put on the agenda.

It is understood that the regulations have corresponding regulations on the responsibilities and obligations of medical personnel and medical and health institutions in occupational safety protection, and also involve relevant details such as insurance compensation.

For example, requires enhanced occupational safety training and supervision, and medical staff themselves should improve their awareness of protection; Medical units provide adequate protective equipment, rationally allocate human resources, and create a good working environment;Establish an exposure source tracking system to clarify the responsibilities and Obligations;Establish a standardized reporting and monitoring system, and standardize reporting and processing procedures;Establish a systematic medical staff career Expose support systems, etc..

We look forward to the further promotion and implementation of these policies across the country and become the patron saint of our medical staff!

The healer cannot heal himself, but he must learn to save himselfNEJM: learn to deal with it correctly It is pessimistic to say that any medical worker may not be able to escape occupational exposure. When faced with optimism when it happens, it can have unexpected benefits.

According to a review published in the journal NEJM, the research team conducted A study on the living and psychological states of 50,000 doctors after occupational exposure showed that:Only by fully understanding occupational exposure, doing psychological construction in advance, and taking corrective measures, it is possible to get rid of Unhealthy mental state, return to career.

then, the study also introduced some of the correct treatment of occupational exposure infection.

Routinely, medical staff should wash the wounded skin with running water or soapy water immediately after occupational exposure, and rinse the mucosa with normal saline repeatedly; And press the skin around the wound, squeeze out the contaminated blood, and then rinse with soapy water; after rinsing, do not bandage, use 75% or 0.5% iodine to fully disinfect.

For typical infectious diseases, this study gives specific treatment methods:

Treat HIV :

Assess the exposure source disease load to determine that preventive medication should be started as soon as possible after occupational HIV exposure, preferably within 4 hours , no more than 24 hours at the latest;

more than 24 hours, preventive medication should also be implemented. Two reverse transcriptase inhibitors, using conventional therapeutic doses, were taken for 28 consecutive days. For example, Shuangtaizhi (AZT and 3TC combined preparation) 300mg/time, twice a day, for 28 consecutive days or refer to the antiviral treatment guide.

Exposed persons should be tested for HIV antibodies at 6 weeks, 12 weeks, 6 months, and 12 months immediately after exposure.

Treatment of hepatitis B:

After routine handling, if HbsAg positive or If the HBs is positive, no special treatment is required. If the anti-HBs titer is low (<10IU/mI), the hepatitis B vaccine needs to be boosted once (5ug); Both HbsAg and anti-HBs were negative, and the exposed persons should be injected intramuscularly with hepatitis B immune globulin (HBIG) 200U and hepatitis B vaccine. , 8 weeks, and 12 weeks to test two and a half pairs of hepatitis B; Intramuscular injection of hepatitis B immunoglobulin (HBIG) 200U, and follow-up treatment according to relevant principles.

Treatment of syphilis:

If the source of exposure (patient) RPR (or VDRL) presents If it is positive, it should be confirmed by TPHA. If it is still positive, the acupuncture person should receive penicillin drug treatment as soon as possible. The earlier the treatment, the lower the probability of syphilis infection.

It is recommended that 2.4 million units of long-acting penicillin be injected once a week, and 1.2 million units should be injected into each buttock for two consecutive weeks. For those allergic to penicillin, erythromycin can be used.

Syphilis antibody test should be performed 1 month and 3 months after stopping the drug; if the patient is TPHA negative, the acupuncture person still needs to be tracked regularly.

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Finally, we hope that every professional exposed Medical staff can be treated well, this is the wish of Mace Medical!

References:[1]. Investigation and analysis of occupational exposure and protection of medical staff in China-Chinese Journal of Infection Control, September 2016 Volume 15 Issue 9[2].Occupational exposure to HIVWriting | Alaska TreasureEditor| Alaska Treasure< /span>download Metz Medicine APP

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