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Blood in hydrogen peroxide dispenser

Question: 

I'm a soon to be a doctor med student working in the Emergency Department of my local hospital. We often use a portable hydrogen peroxide dispenser for cleaning wounds, last Saturday a women came in with a small wound due to an accident with a fork. I started cleaning her and notice that the tip of the dispenser touched the wound, there was no visible blood in it but I assume there may have been some contamination. After I finish with her, I dumped the dispenser in a tub we use for cleaning reusable items like steel trays and such. A few minutes later I saw the same dispenser outside the tub, mounted and refiled with peroxide, ready for use. So I tell one of the nurses what happen and ask her if it was okay to keep using the dispenser given the fact that the tip of it touched someone else wound (and maybe even blood, although I couldn't see any of it), she say the dispenser is already clean and it's perfectly okay to keep using it (just to clarify, the only cleaning it may have got was just a quick bath in tap water, nothing more). Then a new patient came in, it was woman with a dog bite lesion, small in size but certainly profound and actively bleeding, so it was my task to clean her wound again (using the same dispenser of course). I dumped some peroxide in a white tissue looking for signs of visible blood in the peroxide dispenser, it seems clean, there was no visible blood, so I just use it again to clean that dog bite.

I want to know if (in the context cited above) there is some risk that blood in the tip of a peroxide dispenser infected someone else with HIV or any other common blood borne disease. Also I would love to know if this situation constitutes a negligent act from my part or a professional misconduct (I know this last question may exceed the helpline objectives, but I want to clarify that I'm specially referring to the risk of exposing a patient to the HIV virus).

I will really appreciate any answers, this whole thing keep me thinking for days and I'm honestly terrified by the idea that mistakes like that could compromise the most important thing I keep in mind as a future doctor, that is to do no harm. Thanks for your time and excuse my poor english. Goodbye

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of HIV transmission through the use of a hydrogen peroxide dispenser that came into contact with blood. From the information given, this scenario is determined to be No Risk (transmission of HIV is not possible in the given scenario).

The scenario mentioned above does not meet the three components of the Transmission Equation. According to the CDC, "HIV does not survive long outside the human body (such as on surfaces), and it cannot reproduce outside a human host" (1). Another important factor in this scenario is the hydrogen peroxide. It has been shown that amounts as low at 0.3% hydrogen peroxide can inactivate the HIV virus (2). With these facts in mind, it is very unlikely that HIV transmission would occur under these circumstances.

Recommendation: No need for HIV test with the scenario provided, refer to a physician for other health related questions.

Regards,

AIDS Vancouver Helpline/Online, Marie