Episode Transcript
Announcer: Is it bad enough to go to the Emergency Room or isn't it? Find out now. This is E.R. or Not on The Scope.
Interviewer: Time for another edition of E.R. or Not. See if you can figure this one out. We're with Dr. Troy Madsen, emergency room physician at University of Utah Hospital. Dr. Madsen, E.R. or not... I get someone else's blood on me. Is that a reason to go to the E.R. or do you just wipe it off and go on with your day? E.R. or not?
Dr. Madsen: It's going to completely depend on who the person is who got the blood on you and where you got the blood.
Interviewer: Okay.
Dr. Madsen: So the cases where you probably don't need to go to the E.R.: let's say it's a family member and they've been injured at home. You get some blood on you, you know this person. And the reason we're talking about E.R. or not is because we're talking about getting some sort of disease from the blood. And the specific disease we're talking about is, number one, HIV; number two, hepatitis.
Interviewer: Those are the two...
Dr. Madsen: Those are the two we worry about.
Interviewer: Okay.
Dr. Madsen: So if it's a family member you know them, you know their medical history. It's probably not an issue. But if this is someone who you don't know and you don't know if they could have HIV or hepatitis and you get this blood on you then it depends where did you get the blood?
Interviewer: Okay.
Dr. Madsen: If it's just on your skin it's probably not a problem. But if you have cracks in your skin, anything where it could get under the skin or if you get it in your eye or in your mouth. We call them mucus membranes. Those are situations where you need to go to the E.R..
Interviewer: Okay
Dr. Madsen: So, again, it's number one, who's the blood from? Do they potentially have any risks for these things? Number two, is it blood that could get into your body?
Interviewer: All right. And like that right there, see how I do that to my thumbs?
Dr. Madsen: Yeah.
Interviewer: If I got blood on my thumb there where I tend to pick, is that a bad . . .
Dr. Madsen: That's a bad spot.
Interviewer: That's a bad spot. Okay.
Dr. Madsen: You probably want to stop picking that because you've created a nice little entry point there for someone to get some blood on you if accidentally.
Interviewer: Sure.
Dr. Madsen: And we all get those things in the winter. What I use is hand sanitizer at work and I'm using hand sanitizer probably 100 times a day and my skin gets cracked.
Interviewer: Washing your hands all the time.
Dr. Madsen: Yeah.
Interviewer: Yeah.
Dr. Madsen: And so you get blood on that kind of thing where you've got cracks, it could be an issue.
Interviewer: What about like right here where I had a cut and it's scabbed over?
Dr. Madsen: I would err on the side of caution.
Interviewer: Okay.
Dr. Madsen: You know, anything where the skin is not completely intact, if it's blood from a person where you don't know could they potentially have HIV or hepatitis err on the side of caution and then we can kind of evaluate things, talk through things with you and decide what's the best approach here.
Interviewer: Just even one little drop?
Dr. Madsen: Yeah.
Interviewer: Does quantity matter in this scenario?
Dr. Madsen: It does. The more blood the higher the risk, really large exposures. But certainly even one small drop on that kind of spot can potentially be an issue.
Interviewer: And these two things, obviously HIV most people know, hepatitis. They're serious enough you don't want them.
Dr. Madsen: No.
Interviewer: I mean, what would you even do? So I get blood on this little open area and I go to the E.R.. What are you even going to do at that point? Isn't it too late?
Dr. Madsen: Yeah. Well, it's not. For hepatitis, usually there's not a lot of things we can do right then but usually what we'll do is do blood testing right then on you. And the reason we do that is to make sure that for some reason that you don't already have hepatitis or HIV, not from that blood but from something else. And then we have you do follow-up testing.
Now if the concern for HIV is high enough where you had a lot of blood and it could be through a point where there's an entry point there and the person that the blood is from is high risk for HIV-either due to multiple sexual contacts or due to drug use if we know anything about this person-then we start to err on the side of caution. And we can give you medication that you take that will prevent HIV. You take it for a month. It's not a pleasant medication to take. It can cause a lot of nausea, vomiting. But it can potentially prevent HIV.
And it's probably worth pointing out as well that even though we're talking about this, we are talking about serious diseases, the risk of HIV is not super high. If you were to take a needle from someone that has HIV and then stick that needle in a vein on your own body, your risk of getting HIV from that is less than 1%.
Interviewer: Oh, really?
Dr. Madsen: So it's not really high.
Interviewer: Yeah.
Dr. Madsen: But it's one of those things where obviously HIV, there's no cure for it. There are certain medications and people now with HIV live full, normal lives. It's not like it's the death sentence that it was when we talked about it in the '80s. But it's something you don't want so if there is that risk we do like to make sure you're on medication to prevent that.
Interviewer: Okay. And what about hepatitis?
Dr. Madsen: In hepatitis, again one of those things where people will come in the E.R. after potentially being exposed. If you haven't had vaccines already for hepatitis B, we make sure you get those vaccines. That's something that a lot of health care workers have. Those of us who work in health care have to have that. But that's something where we can give you those vaccines to prevent you from developing hepatitis.
Interviewer: So there are things that can be done?
Dr. Madsen: There are.
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updated: November 16, 2018
originally published: April 22, 2014