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Old 09-14-2012
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Question Ethics - HIV testing?

A)Does HIV testing require consent? I am assuming answer to be yes, then;

B) What to do when a medical personnel gets needle stick injury? Do we test the patients blood with his consent for HIV? What if he denies consent?
We have to test the patient for the safety of medical personel isnt it??


C) If we test the blood even when patient denies consent then obviously we cant give him the result ! what do we do if he tests positive? What about reporting n protecting his contacts?

I have no idea about these issues please help..

Thanks
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Old 09-14-2012
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Default my opinion

[QUOTE=dr.nitowl;147253]A)Does HIV testing require consent? I am assuming answer to be yes, then;

B) What to do when a medical personnel gets needle stick injury? Do we test the patients blood with his consent for HIV? What if he denies consent?
We have to test the patient for the safety of medical personel isnt it??


C) If we test the blood even when patient denies consent then obviously we cant give him the result ! what do we do if he tests positive? What about reporting n protecting his contacts?

A)yes
B)seek his consent,if he denies,then get a court order/get ethics committe invoved?
C)if +ve,inform his spouse and CDC
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Old 09-14-2012
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Quote:
Originally Posted by dr.nitowl View Post
A)Does HIV testing require consent? I am assuming answer to be yes, then;

B) What to do when a medical personnel gets needle stick injury? Do we test the patients blood with his consent for HIV? What if he denies consent?
We have to test the patient for the safety of medical personel isnt it??


C) If we test the blood even when patient denies consent then obviously we cant give him the result ! what do we do if he tests positive? What about reporting n protecting his contacts?

I have no idea about these issues please help..

Thanks
A-Well, my understanding, we must have a consent from the pt. to test the pt. for HV.
B- Still if the pt. got needle stick , we can't test without his consent. If her denies we can explain the benefits of having the test done.
C-In case he agrees to do the test and the result came back positive, we don't break the our pt. confidentiality unless he discloses that he will not tell his sexual partner about it.
But always try to explain to pt. the advantage of being tested, treated.And also to tell ur partner about your HIV result.
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Old 09-14-2012
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Originally Posted by Anders View Post
A-Well, my understanding, we must have a consent from the pt. to test the pt. for HV.
B- Still if the pt. got needle stick , we can't test without his consent. If her denies we can explain the benefits of having the test done.
C-In case he agrees to do the test and the result came back positive, we don't break the our pt. confidentiality unless he discloses that he will not tell his sexual partner about it.
But always try to explain to pt. the advantage of being tested, treated.And also to tell ur partner about your HIV result.


HIV is a reportable dx.it's one of the cases where patient's confidentiality has to be breached without breaking the law.what we should do is to encourage the patient to first speak to their spouse before we step in to counsel both partners and encourage the spouse to be tested too?
That's what I will do
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Old 09-14-2012
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HIV is a reportable dx.it's one of the cases where patient's confidentiality has to be breached without breaking the law.what we should do is to encourage the patient to first speak to their spouse before we step in to counsel both partners and encourage the spouse to be tested too?
That's what I will do
Yes, you are right , but to me first step talk to the pt himself, may be the pt. lacks of the knowledge about HIV.
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Old 09-14-2012
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Quote:
Originally Posted by Anders View Post
A-Well, my understanding, we must have a consent from the pt. to test the pt. for HV.
B- Still if the pt. got needle stick , we can't test without his consent. If her denies we can explain the benefits of having the test done.
C-In case he agrees to do the test and the result came back positive, we don't break the our pt. confidentiality unless he discloses that he will not tell his sexual partner about it.
But always try to explain to pt. the advantage of being tested, treated.And also to tell ur partner about your HIV result.

Thanks. Am sorry my question isnt clear,, what i wanted to know is , when some one giving him medical care like a nurse gets a needle prick from his blood. and if he denies getting tested.. what we do ? If it were his health issue we could leave it to him whether to be tested or not, but now its health issue of the nurse...
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Default Accident exposure

first you ask the pt if refused the med student shd do the er washing with oh compressing to make it bleed more.
if the pt denies the med student shd be be in anti viral and check his blood after 6months had it taught this way in infection control
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Old 09-14-2012
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Quote:
Originally Posted by Dodi Jacob View Post
first you ask the pt if refused the med student shd do the er washing with oh compressing to make it bleed more.
if the pt denies the med student shd be be in anti viral and check his blood after 6months had it taught this way in infection control
that answer not makes sense for this question(in exams), but that may be true indeed in real world...one of my friend was accidentally pinpricked a pt. when tested that pt. turned to be positive during our postings and my friend also used prophylaxis zidovudine for 3 months....
but in USMLE such answers are not provided in options i guess...i think the most appropriate answer would be better explain the pt. more abt AIDS and know what bothers him of not being tested for HIV and convince him for test...but without his consent we can't do

c) and if he accepts for the test and turns out to be positive.....inform the pt. first( he accepted for testing ) ..then if he wants it to be confidential then break it informing partner
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