Universal Precautions for Medical Rescuers

Body Substance Isolation for Everyone

Stay safe. If you have protective equipment, wear it. Rod Brouhard

The most common hazard faced by medical rescuers is the threat of communicable disease. Professional rescuers follow standard practices and use personal protective euipment (PPE) when providing medical care to victims. These practices are commonly referred to as universal precautions or body substance isolation (BSI).

Universal Precautions

  1. wash hands before and after each medical procedure (may use a waterless hand cleaner)
  1. wear gloves whenever there is a possiblity of coming in contact with blood or other potentially infectious materials (body fluids and tissues)
  2. wear full-body gowns whenever there is a possibility of blood splashing onto the rescuer
  3. wear face masks and eye protection whenever there is a possibility of blood splashing into the rescuer's face
  4. dispose of all contaminated sharp objects in an appropriate puncture-proof container
  5. dispose of all contaminated personal protective equipment in an appropriate container marked for bio-hazardous waste

Bloodborne Pathogen Exposure

Bloodborne pathogens are diseases passed from person to person through contact with infected blood or body tissues. Sometimes, other body fluids, such as semen or vaginal secretions, can also contain enough of the pathogen to be infectious. Notable bloodborne pathogens are human immunodeficiency virus (HIV) and Hepatits B or C. Universal precautions were developed to protect rescuers specifically from these pathogens.

The best protection from exposure to bloodborne pathogen is with intact skin. Blood getting onto intact skin has very little chance of transmitting any infection into your body. If you have any cuts or scrapes, however, it's like busting a hole in the wall of your house. The virus can walk right in.

That's why we wear gloves with every patient. It's common to have very small cracks and raw areas on our hands, which provide entry points for pathogens.

Try this: put some rubbing alcohol on your hands. If it stings, that means the rubbing alcohol is getting through somewhere. You have potential entry points for pathogens. Wear gloves and wash your hands thoroughly after every patient.

Some body surfaces are permeable to pathogens, meaning those surfaces can be healthy and intact but the bugs are coming in anyway. All mucous membranes are that way. Protect those surfaces, especially when there's sure to be blood. Wear a mask and eye protection to keep blood out of your mouth, nose and eyes. Pathogens can cross mucous membranes in all three places even if you don't have cuts or scrapes.

First Aid Kits

Lay rescuers should consider following universal precautions as much as possible. To adequately follow universal precautions, a rescuer must have appropriate personal protective euipment available.

Make sure first aid kits contain - at a minimum - gloves, mask and eye protection.

Not every patient has a communicable disease, but there's no way to know who does and who doesn't. Because of that, we take these precautions with every patient, hence the term universal. If you do administer first aid to a patient and later discover that the patient had a communicable disease, following these guidelines means you should be protected. Contact your healthcare provider if you have any questions about a specific case.

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