Universal precautions

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Universal precautions refers to the practice, in medicine, of avoiding contact with patients' bodily fluids, by means of the wearing of nonporous articles such as medical gloves, goggles, and face shields. Medical instruments, especially scalpels and hypodermic needles should be handled carefully and disposed of properly in a sharps container. Pathogens fall into two broad categories, bloodborne (carried in the body fluids) and airborne. Standard universal precautions cover both types.

Universal precautions should be practiced in any environment where workers are exposed to bodily fluids, such as:

• Blood
• Semen
• Vaginal secretions
• Synovial fluid
• Amniotic fluid
• Cerebrospinal fluid
• Pleural fluid
• Peritoneal fluid
• Pericardial fluid

Bodily fluids that do not require such precautions include:

• Feces
• Nasal secretions
• Urine
• Vomitus
• Perspiration
• Sputum
• Saliva (In the dental setting, saliva is likely to be contaminated with blood, and should be handled properly.)

[edit] Discussion

Universal precautions are the infection control techniques that were recommended following the AIDS outbreak in the 1980s. Essentially it means that every patient is treated as if they are infected and therefore precautions are taken to minimize risk. Essentially, universal precautions are good hygiene habits, such as hand washing and the use of gloves and other barriers, correct sharps handling, and aseptic techniques.

Additional precautions are used in addition to universal precautions for patients who are known or suspected to have an infectious condition, and vary depending on the infection control needs of that patient. Additional precautions are not needed for blood-borne infections, unless there are complicating factors.

Conditions indicating additional precautions:

• Prion diseases (e.g., Creutzfeldt-Jakob disease)
• Diseases with air-borne transmission (e.g., tuberculosis)
• Diseases with droplet transmission (e.g., mumps, rubella, influenza, pertussis)
• Transmission by direct or indirect contact with dried skin (e.g., colonisation with MRSA) or contaminated surfaces

or any combination of the above.

Universal precautions are recommended not only for doctors, nurses and patients, but for health care support workers. Some support workers, most notably laundry and housekeeping staff, may be required to come into contact with patients or bodily fluids.

Protective clothing may include but is not limited to:

• Barrier gowns
• Gloves
• Eyewear (goggles or glasses)
• Face shields
• Hair nets
• Shoe coverings

[edit] See also

• Body substance isolation
• Recommendations for Prevention of HIV Transmission in Health-Care Settings -- possible first use of the term "universal precautions".
• VHFs