To expect to be told if a patient of mine is HIV positive

[NCISaddict]

If I have asked them if they have any medical conditions I should be aware of?
I am aware that it is very difficult to catch and that they may have encountered judgemental attitudes in the past, which is totally unacceptable but if your condition could put your HCP at some risk (even though it would be small) then surely you should inform them?

unless it's casual contact, I'd assume everyone is HIV+ untill I know otherwise.
But appreciate in some professions you can't always be 100% safe.
Hope you're ok op.

fidel, for a patient to disclose their status

for lots of different reasons

You mean if the patient is insensible AF?

I suppose I'm just focussing on the reasonable expectation a paramedic should be able to have that a concious, coherent patient who understands the question should not lie.

The problem is, I can walk into a room or be bending over a patient and they vomit suddenly and unexpectedly with the distinct possibility of it going in my mouth/eye.
I do get that they may well be embarrassed and I do my level best not to add to that when patients do tell me.
This case seemed different as the patient told the A&E staff immediately and quite openly (which was how I found out) whereas I, who had been holding their vomit bowl and clearing up the vomit didn't seem to warrant being told.

I am a HCP and just like you I've had people not telling me things. Sometimes because they genuinely don't think about it, sometimes because they are scared to do so having been on the receiving end of many nasty responses. I've also seen people looking at me genuinely surprised when I mention protecting myself.

I agree that they should tell people and trust HCP that the info is for their best care.
However, maybe it's also up to us HCP (in general) to actually prove to their patients that actually they can trust us too (and not look horrified, not wanting to touch them, making assumptions as how they got the illness etc etc). Clearly lots of them have had very bad experiences :(:(

Of course the patient shouldn't lie to a hcp (for their own benefit it's better that the hcp had the full picture of what's going on with them) but that's not life.

As House says, "everybody lies". You assume everyone has a communicable disease and treat them accordingly.

conscious^

YABU. As everyone else has said you assume everyone could have some sort of communicable disease and take appropriate precautions. Obviously there is still some element of risk, like you said eye protectionn or behaviour of a patient (biting etc) means sometimes you are put at risk but the risk is miniscule.
Not entirely sure what aseptic technique has got to do with it.

This case seemed different as the patient told the A&E staff immediately and quite openly (which was how I found out) whereas I, who had been holding their vomit bowl and clearing up the vomit didn't seem to warrant being told.

They probably didn't equate vomiting with passing on HIV.

So what you are saying is that you felt the patient didn't respect you in the same way than the nurses at A&E?

I suspect that this person didn't even think about being infectious with the vomitting etc.. but thought it was an important info for nusres for the treatment iyswim?

I was a 'Buddy' for people with HIV and No, they don't have to declare their Status and nor should they.

I'm surprised as a Paramedic, you aren't aware of that.

There's a near impossible risk of transmission.

For the person who asked about Tattooing, again, a person doesn't have to declare their Status.

Same with Cosmetic procedures.

There's a lot of undetected HIV and everyone should follow their correct procedures, same with Hepatitis etc.

OP if you mean 'Was the patient's behaviour unacceptable?' then I say yes it was.

Doubtless everyone who is saying 'but don't rely on it' also have a point.

Isn't it next to impossible to become HIV+ clearing up vomit, for example? Or even small amounts of vomit in your eye or mouth? I know it's worrying.

Hepatitis worried me very badly when I worked with street involved people. But HIV didn't worry me unduly.

I know most of the people would tell me if they had either, but I assumed not everyone would know, or tell me if they did.

The thing is if, for whatever reason, something happens that could lead to infection, then you wouldn't take the same attitude re dealing with it would you?

OP did the Vomit have Blood in it?

If not, then surely you know that there'd be absolutely no risk of transmission?

This worries me, actually, do you think your Communicable Disease Training has been adequate?

Go and speak to a Supervisor and they'll explain why the Patient doesn't have to declare their Status.

I didn't know vomiting was a way of transmitting hiv tbh, although i would assume someone who has the disease would be far more informed than me.

I was treated at a camp medical centre with a migraine (I hadn't had them before), and when asked if I was generally healthy answered yes... Then when asked about medication I listed three prescription medicines I take daily... Oops. I equated the question with acute physical health, I have ongoing minor physical and more major MH issues, none of them relevant at the time.

That's because it isn't, notme

I'm not sure if there are ANY cases of HIV transmission via the eye.

I'm a doctor and see lots of acutely unwell people in A&E or on the medical admissions unit and this doesn't worry me a bit, quite honestly.

I do like to know if people have HIV because the drugs often have a lot of interactions with anything I might prescribe and there are some conditions that are more likely in an HIV positive patient, but I consider the risk of transmission incredibly low.

Even with a needlestick injury from a syringe of HIV positive blood, the risk of transmission is 1 in 365. (The risks for hepatitis B, to compare, are about 1:30, whereas the risk with Hepatitis A is 1:3.)

Has anyone ever caught hiv through the eyes. I'm not sure if there has even been a single proven case .

the is for the OP though, not you.

I'm very suprised a paramedic wouldn't know this too, and agree with birds thst perhaps some further training would be an excellent idea.

So it's about perceived levels of respect?

That assumes a patients condition is stable, the circumstances and surroundings are interchangeable and the relationship with different individuals in different contexts are the same. It also assumes that the patient knows exactly what risks there are in situations they might not have experienced before... And can think on their feet whilst in fear and pain.

Someone I worked with was spat in the face by a patient who had just bit his tongue and ended up with blood all.over her face and possibly in her eyes. He was HIV+ and while she was given the PEP medication the doctors said it was almost impossible she would have caught it (she was negative in the follow up tests).

""Off topic is HIV getting weaker?""

No, the drugs and treatments are getting better. We know so much about the Virus and how it works in the body.

I've taken People whilst they undergo trials, we're in Liverpool, we have excellent Consultants and Clinics.

It's Rare that anyone in the developed World dies of AIDS.

You need never get to an AIDS stage, anymore.

stairway, I've just been hunting in the medical literature and I can't find one reported case.