Tuesday, November 28, 2006

Needless

I'm an Anaesthetist. I put in intravenous drips & central lines; I draw up various drugs from glass ampoules, I take blood and I put in stitches. I handle a variety of sharp things every day.

It was bound to happen sooner or later.

While stitching a patient's arterial line in place yesterday, the needle accidentally went through my glove and pricked my finger. Bugger. Hassle.

Sadly there is no equivalent to the three-second rule* for needlestick injuries.

It's a common occurence in a hospital and can happen to almost anyone; that's why there are strict protocols to follow when it does happen because of the risk of catching blood-transmitted diseases (eg squeeze out any blood, run under a tap for 5 mins, contact the Occupational Health department, fill in forms, etc). Did all that. And thankfully my patient was low risk for carrying anything horrid and it was only a minor incident.

My main problem now was that I had to provide a blood sample for the lab for storage.

Now I can quite happily stick needles into other people. No problemo signor. Eez-a no big-a deal. Awake, asleep, adult, kid, any size, any needle - lemme at 'em.
As the 6th law of The House of God states: "THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A #14 NEEDLE AND A GOOD STRONG ARM"

I've lost count of the number of patients who've said to me
- "I don't like needles, Doc"
(It's always "Doc", never Doctor - does this happen in with other professions? Den? Vic? Who?)
And each time, I reassure them, whoever they are, young or old
- "It's not so bad. It's just a little scratch". That's what I tell other people.

But I lie. It is so bad. It's a hollow metal spike going through the skin.

And in this case, through my skin. And it hurts. Ow. More Ow. Still Ow. Comeoncomeoncomeoncomeon....

I had foolishly agreed to let a newly-qualified doctor friend of mine with a spare minute take my blood sample. Despite the threats encouragement I gave him beforehand, he didn't get it first time. Of course, I wasn't initially aware of this because I was looking the other way, remoulding the plastic armrest of the chair as I gripped it tightly with the other hand. I did not cry.

It hurt though - and when he pulled the needle out, it still hurt.
I pressed a cotton-gauze pad against the site & I mumbled "thanks" but I was thinking "I hope you fall down eighteen flights of stairs onto a spike - why did it hurt so much, you bastard?"


After a few minutes of applying pressure, I took off the gauze. A purple-black bubble started to grow under my skin between two holes which started to leak red**. Oops. Slapped the gauze back on & asked the nurse for a fresh one.

It was at that very moment that the Consultant barked for me to come over and tell the assembled team about our new patient immediately.

So as I was presenting this man's case to an assortment of doctors, nurses & physiotherapists, Sister was knelt beside me putting a tight dressing on the front of my bleeding elbow. It must've looked absolutely ridiculous.

I tried not to think about it (it's just a little blood test for fuck's sake) but my elbow stayed sore the whole day.

I'm such a wuss.
In fact I've still got a plaster on it now...


Don't even get me started on pulling off plasters...

-------------------------------------------------------------------------

* for food which falls on the floor - if you pick it up within 3 seconds, it's still clean and safe to eat (well-known medical fact)

** Yes, I know- I probably ought to have a clotting test done. Did I mention I don't like needles...

28 Comments:

At November 28, 2006 3:29 PM, Anonymous Anonymous said...

I've started taking a towel with me when I do kiddie cannulations, to catch all the excess blood - the last one looked like someone had given birth on it

 
At November 28, 2006 4:36 PM, Anonymous Anonymous said...

We can assume you are not at the front of the queue when the Blood Donation van comes to town then...

 
At November 28, 2006 6:18 PM, Anonymous Anonymous said...

Why do doctors always say a 'little scratch' and not a 'small prick'?

 
At November 28, 2006 6:31 PM, Anonymous Anonymous said...

Get a grip, Biswas. It could have been worse, it could have been someone like me trying to put in a venflon. "It's just a wee sharp scratch now, then I'll somehow go through the back of your vein and leave you with a rather attractive mini-haematoma"

 
At November 28, 2006 7:48 PM, Anonymous Anonymous said...

true true, why do doctors say 'little scratch' and not 'small prick' or rather 'huge-ass-javelin, please mind out'

 
At November 28, 2006 8:51 PM, Anonymous Anonymous said...

"It's always "Doc", never Doctor - does this happen in with other professions? Den? Vic? Who?"

Hmmm - someone has been watching waaaay too much EastEnders! Not having Dirty Den withdrawaa are you? Can you get that from needlestick? Hmmmmm......

 
At November 28, 2006 9:12 PM, Anonymous Anonymous said...

At least you get a title in your profession. Try being part of "The IT Crowd" for a while - we are the clown shoes of the business community! I was thinking about trying to get Microsoft to change their certification courses so that instead of becoming MS certified or "MCSE" that instead you became "Grand High Poobah" - a name to strike fear into the users! It's a work in progress but one day...MWUAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA

 
At November 28, 2006 9:49 PM, Anonymous Anonymous said...

see? this is a better blog. i laughed at your expense.

No. i'm not sadistic

 
At November 29, 2006 12:27 AM, Blogger Suman said...

Saying "You're going to get a prick in your hand" is good for distracting patients; but it tends to distract the gay ODPs as well too...

 
At November 29, 2006 10:12 AM, Anonymous Anonymous said...

Gay ODPs? what does ODP stand for?

 
At November 29, 2006 10:25 AM, Anonymous Anonymous said...

Operating department practitioner.

Even I know that, and I'm a geologist.

 
At November 29, 2006 10:25 AM, Blogger Dr James Shorthouse said...

ODP... hmmmm
Out (the) Door Prettydamnquick
Obstructive Destruction (of the) Pooranaesthetist
Suman, if its any consolation, I hate needles too: why do Occy health always take at least 5 goes?

 
At November 29, 2006 5:00 PM, Anonymous Anonymous said...

When the Gasbag announces that it's just a little prick, most ODP's think "Yeah but the prick has a needle in his hand".

By the way, never, ever, ever ask an ODP to take blood off you. Just remember how much sh*t the ODP has taken of you & your profession, that week alone. OOOH, that'll hurt.

 
At November 29, 2006 7:31 PM, Anonymous Anonymous said...

Hmmm... I read this post about an hour before I went to donate blood for the first time ever (yay, three years late but, yay!)... not the best of ideas.

However it was fine, even though they couldn't find a big enough vein and tried on a small one which worked but gave me a bruise while I was still donating (should that happen?!?)

The worst part is the ceremonial ripping off of the plaster whilst screaming. I'm putting it off until completely necessary to do so. Hoping my brother doesn't get there first :|

 
At November 29, 2006 8:50 PM, Anonymous Anonymous said...

Oh god, all this talk of needles! Don't! Last time I had blood tests done I questioned the poor guy for about 5 mins before I let him at me.

I've got to go and get two more needles in me next week and I get to see OH somwhere for my course soon and they will probably take my blood too.

I really hate it. And by rights, should have probably been put off it forever following the Biggest. Bruise. You've. Ever. Seen. Following. A. Blood Donation. Fiasco. (It really was huge- and it hurt lots. And we stopped early with a quarter of a blood bag). Despite that, I still donate blood. But I can't right now (shame) because of all the injections recently. Im devastated- no, really.

Glad you didn't get (hopefully) any horrible diseases. My mate did that in a sexual health clinic a few months ago! Fuck that!

(Not got horrible diseases, stuck a needle in her that could have given her horrible dieases).

 
At November 29, 2006 9:13 PM, Anonymous Anonymous said...

Must admit I'm a wuss when it comes to needles too - had my (very late) booster MMR the other day and had to stay sitting with head between legs for a good couple of minutes, waiting for my ears to stop ringing and the blood to get back to my fingertips.

But...

I was recently at a GP practice nearby (doing GP block as part of 5th yr med) and I sat in on a childhood immunisation clinic. Naturally, I thought the older children would be worse - they've been here before and know exactly whats coming (compared to the poor babies who have no idea).

There I was, cringing in the corner bracing myself for the screams and tears from a load of 4 year olds, but in fact they were the best patients - cunningly distracted with a talking Thomas the Tank Engine clock by the Health Visitor, they didn't feel a thing - not a sound! And they all got a sticker!!Well impressive!!

 
At November 29, 2006 9:39 PM, Anonymous Anonymous said...

I had to have bloods done last week - I got them done at the phelbotomy dept of my current placement hospital, rather than trek half way across London.

I told them about my fear/hate of needles, but I was a brave girl and...

...I GOT A STICKER!! I looked well hard on the ward that afternoon!

*Back of the net!*

 
At November 30, 2006 5:24 PM, Anonymous Anonymous said...

Pfft... clotting screen for bleeding a little bit? You'll be fine. It happens to my patients all the time and there's nothing wrong with them...

*except perhaps the prannock trying to take their blood...*

 
At November 30, 2006 5:34 PM, Anonymous Anonymous said...

you're all wimps.

diabetic here.

 
At November 30, 2006 8:13 PM, Anonymous Anonymous said...

So you went straight to occupational health, no dawdling along the way? To get say some Emla cream?

 
At November 30, 2006 9:02 PM, Anonymous Anonymous said...

http://www.madhatter.it/art/originalcharacters/a-good-surgeon.jpg

this could be you...

 
At December 01, 2006 11:13 PM, Anonymous Anonymous said...

Suman, you are clearly a big Wuss.

I get my first year students to practise taking blood from me.

I need to practise cannulating with a grey venflon. Any takers?

Claire

 
At December 13, 2006 3:23 PM, Anonymous Anonymous said...

I just did the exact same thing about two months ago.. I got called back three times now to the Occie Health guys.. When I asked them what they were doing with all this "blood for storage", they said (rather unsurprinsingly) storing it.. I asked, reasonably, for what purpose are the Occupational Health Department storing gallons of my blood that they have confessed to having no intention of testing for anything.. The nurse shrugged and said she didn't know..
Concerning??
It all has a bit of a conspiratorial ring to it, methinks..

 
At December 27, 2006 3:56 AM, Anonymous Anonymous said...

I'm glad that you plugged House of God; a still relevant book, which must, it seems, apply well in the UK (I'm in the States, but have medical friends in the UK).

The CDC in the US (and others) promote a staged approach to post-exposure care. Medium and high-risk folks are offered drugs.

 
At January 27, 2007 1:28 AM, Blogger takesmybreathaway said...

I always knew deep down that you Anaesthetists aren't as brave as your patients. I think I'm in a fairly good position to call you a WIMP for the needle thing (not the needle stick thing). Seriously though its good to see things from a dr's point of view, thanks for sharing.

Rachy (a patient) xxx

 
At January 30, 2007 10:28 PM, Blogger paul said...

m

 
At January 30, 2007 10:32 PM, Blogger paul said...

I am THE best peripheral vascular access person in the country. I will kick any anaesthetist ass around the anaesthetic room if the choose to take me on at 1st time placement in veins that can not be seen nor felt untill they are begging for a teaching session and mentorship in my ART.

 
At January 30, 2007 10:35 PM, Blogger paul said...

Senior operating department practitioner will humble any consultant anaesthetist in the UK at 1st time vascular access placement in patients with no visible or palpable veins....FACT

 

Post a Comment

<< Home