America is bleeding. We are in the throes of a growing epidemic of gun violence, with mass shootings becoming a daily tragedy. Vehicle-related fatalities have increased by 10.5% over the past year. Even shark attacks are on the increase. But that’s okay; You are safe. You weren’t injured, or at least not seriously. Now, however, after the chaos and confusion, you realize that there is blood – someone else’s blood – on you. You should check that.
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We have spent the last few years getting used to a new, more hygienic normal, in which we have become painfully aware of the risks of simply breathing on each other. Yet we rarely consider the consequences of bleeding on each other. It certainly hadn’t crossed my mind in any concrete way until I recently found myself in the path of an elderly pedestrian with a traumatic brain injury. I waited for the ambulance with him, clumsily trying to bandage his wound with a paper towel. After the paramedics arrived and he was on his way to the hospital, I washed myself in the restrooms of a nearby restaurant. I came home, took a shower and washed my clothes. And I called my doctor.
Although the risks of infection from superficial physical contact with blood are relatively low, this does not mean that they should automatically be ruled out following an accident or an act of violence. The CDC estimates that 2.4 to 4.7 million Americans are living with hepatitis C, and up to 2.2 million are living with hepatitis B. More than half of them don’t know that ‘they have their conditions, which can cause mild or more severe, long-term symptoms. So it’s worth it for all of us to understand what healthcare workers, who have well-thought-out protocols for these types of events, know about blood exposure. Being careful and prepared can be especially important when you don’t know the health status of others involved in your incident.
First, you need to know what you are risking and not running.
“With regard to COVID-19, there is no risk of contracting it through the blood because it is not the mode of transmission of SARS-CoV-2. It is through respiratory secretions/fluids” , says Erica Susky, an infection control practitioner in Toronto. It’s not a bad idea, however, to consider how close you may have been to others, for how long, and in what ventilated space.
“For blood-borne viruses (HIV, hepatitis B and C), exposure can occur with blood but not with other bodily fluids (feces, vomitus, nasal secretions, saliva, sputum or tears),” continues Susky. “Exposure is possible when infected blood comes in contact with non-intact skin, mucous membranes and through the skin through a needle or sharp object. Factors to consider would be if the blood is from an infected person, the amount of virus in the blood, if the exposed person is immune (because there are vaccines against hepatitis B) and the volume of blood involved in the exposure.” And Nancy Mitchell, registered nurse and editor for Assisted Living Center, points out that “Although the most common bloodborne pathogens are HIV, hepatitis B and hepatitis C…there are more than 20 other pathogens that can be transmitted through exposure to blood.”
Next, assess whether the person’s blood could have had a viable entry point into your body. “You have to be concerned if the blood comes in contact with mucous membranes or an opening in the skin,” says Susky. Could the blood get into a fresh cut or wound, or inside your mouth or nose, for example? Otherwise, you’re probably safe. Susky says, “The risk should be absent if it occurred with intact skin or any other physical barrier,” such as clothing.
Regardless of the risk, the sooner and more thoroughly you can wash up, the better (assuming of course that you don’t need to keep evidence of a crime). “It’s important to clean the area immediately,” says Mitchell. “Wash your hands well with warm soapy water and do the same on all parts of the body that have been exposed. Wash your hands again once all the blood has been cleaned up.”
Even though we were outside and I didn’t notice any open cuts on myself while I was with the injured man, I was still tested later for HIV, Hepatitis B and C and COVID-19. I didn’t know him, I didn’t know his state of health. There’s no downside to being careful, and if I wash my hands before I eat, why wouldn’t I want to know if I’ve been exposed to a potentially serious infection? There are relatively simple and effective treatments for blood-borne diseases, but nothing works if you don’t know you have one.
The harsh reality of contemporary life in America is that on any given day, a random accident or an act of mass violence can directly affect your life. And even in the best-case scenario, one in which you walk away unscathed, you could still suffer unforeseen health consequences. It’s hard to think about it, but it’s good to be prepared for it. And as long as we continue to shed blood, we need to know what to do when some of it falls on us.
on protection against infection