LNSLNS

Testing the index patient after a needlestick injury is the prerequisite for optimal medical care for affected medical staff. Awareness of the infectious status of the index patient enables individual therapy and in case of a negative HIV test result prevents potentially serious adverse effect due to post-exposure prophylaxis (HIV-PEP).

In routine clinical practice, however, uncertainty often prevails about the extent to which the patient can be forced to have a blood test in order to avert possible harm to the affected staff members.

From our interdisciplinary perspective we regard testing the index patient as appropriate and usually in accordance with their statutory rights (1).

Recent studies have shown that, in addition to the risk of infection, psychosomatic/psychiatric disorders may develop after a needlestick injury (2). A negative test result that is communicated as rapidly as possible unburdens the staff member, whereas a needlestick injury in an infectious patient should be closely monitored in order to avoid psychological or physical disorders, or at least identify and treat them quickly.

The scenarios described by Dr Teterin outside the hospital require a legal clarification as a first step and as a second step, appropriate communication and organization, in order to also treat non-medical staff (for example, first aiders or police) appropriately.

DOI: 10.3238/arztebl.2013.0420b

PD Dr. med. Sabine Wicker

Betriebsärztlicher Dienst

Klinikum der Johann Wolfgang Goethe-Universität Frankfurt

Sabine.Wicker@kgu.de

Prof. Dr. med. Ingo Marzi

Klinik für Unfall-, Hand- und Wiederherstellungschirurgie

Klinikum der Johann Wolfgang Goethe-Universität Frankfurt

Conflict of interest statement
PD Dr Wicker has received reimbursement of travel and accommodation expenses and received lecture fees from B Braun, BD, BV-Med, and pfm.

Professor Marzi declares that no conflict of interest exists

1.
Wicker S, Gottschalk R, Spickhoff A, Rabenau HF: HIV-Test nach Nadelstichverletzung: Muss der Indexpatient zugestimmt haben? Dtsch Med Wochenschrift 2008; 133: 1517–20 CrossRef MEDLINE
2.
Green B, Griffiths EC: Psychiatric consequences of needlestick injury. Occup Med (Lond) 2013; [epub ahead of print] MEDLINE
3.
Himmelreich H, Rabenau HF, Rindermann M, Stephan C, Bickel M, Marzi I, Wicker S: The management of needlestick injuries. Dtsch Arztebl Int 2013; 110(5): 61–7 VOLLTEXT
1.Wicker S, Gottschalk R, Spickhoff A, Rabenau HF: HIV-Test nach Nadelstichverletzung: Muss der Indexpatient zugestimmt haben? Dtsch Med Wochenschrift 2008; 133: 1517–20 CrossRef MEDLINE
2.Green B, Griffiths EC: Psychiatric consequences of needlestick injury. Occup Med (Lond) 2013; [epub ahead of print] MEDLINE
3.Himmelreich H, Rabenau HF, Rindermann M, Stephan C, Bickel M, Marzi I, Wicker S: The management of needlestick injuries. Dtsch Arztebl Int 2013; 110(5): 61–7 VOLLTEXT

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