BERKELEY, CA (UroToday.com) - Despite being careful in the operating room most surgeons at some point in their life will experience a needle stick injury. Theoretically, one could assume that based on their inexperience surgeons in training are exposed to the highest risk. What is the risk of a needle stick for a surgical resident and how many of these injuries are reported and treated appropriately?

In the June 28th issue of the New England Journal of Medicine, Makary and colleagues from Johns Hopkins report on a study designed to evaluate the prevalence of needle stick injuries among surgical residents. A total of 733 surgical residents in 17 medical centers were confidentially asked about previous needle sticks.

The overall response rate was 95% (699 physicians). If needle sticks occurred, the residents were queried about whether the patient was a high-risk patient (HIV, Hepatitis B or C, IVDA) and whether the needle stick was reported to the Employee Health Clinic. Eighty-three percent of respondents experienced a needle stick injury during their training. Of those residents in their final year 99% had a history of a needle stick which, correlated with the increasing number of exposures as the years of training progressed.

Remarkably, 53% of physicians had been stuck with needles from “high-risk” patients. Of all exposures, only 51% (297 of 578) had been reported to employee health with only 16% of high risk exposures reported. The main reason for not seeking medical attention was lack of time.

This simple yet well designed study validates what we already know: essentially all surgical residents will be stuck by a needle by the end of their training. What is most sobering about these data was that over half of exposures involved a patient with a history of viral hepatitis, HIV, or intravenous drug use. While the risk of exposure of urology residents may be lower due to our high volume of endoscopic cases, as attendings we must speak openly about exposure with our residents and encourage them to document all needle sticks to receive the appropriate counseling.

Makary MA, Al-Attar A, Holzmueller CG, Sexton JB, Syin D, Gilson MM, Sulkowski MS, Pronovost PJ

NEJM. 356(26): 2693-99, June 28 2007

Written by Ricardo Sånchez-Ortiz, MD, a Contributing Editor with UroToday.

Please log-in or register in order to submit comments.

Powered by AkoComment!