Clinician Wire Puncture Injury to the Hand from Chest Compressions on a Patient with a Median Sternotomy: A Case Report

Abstract

Standard precautions, including protections from blood and body fluid exposure, are designed to protect health care pro- viders from infections. Sharps safety practices rarely include the potential for the unconscious patient’s own body to be a potential source of clinician percutaneous injury from sharp objects outside of the perioperative setting. This case report reviews a percutaneous injury to the hand of a physician who was performing chest compressions on a patient with an out-of-hospital cardiac arrest. The 76-year-old patient in cardiac arrest had undergone a medial sternotomy surgery 15 years before the arrest. The sternal wire rotated owing to the initial chest compressions, breaking the clinician’s nitrile glove and producing an open wound on the thenar region of the clinician’s right hand. Application of a 10 3 10 12-ply gauze pack on the chest of the patient in cardiac arrest allowed the resuscitation team to continue with the compres- sions with no further wounds from the wire. This case report is a novel contribution to the published literature and advances standard precautions considerations in patients with out-of- hospital cardiac arrest, with the sternotomy wire from previ- ous surgery as a source of percutaneous clinician injury during chest compression.