Wednesday, December 13, 2006

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 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:
Vaginal secretions
Synovial fluid
Amniotic fluid
Cerebrospinal fluid
Pleural fluid
Peritoneal fluid
Pericardial fluid
Bodily fluids that do not require such precautions include:
Nasal secretions
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. Because universal implies perfect protection, which universal precautions do not provide, however, this term is no longer recommended.
Current recommendations call for a two-tiered system, using the terms standard and additional precautions. Standard precautions apply to all patients no matter what their infectious status is known or suspected to be. This applies to blood (wet and dry) and ALL bodily fluids except sweat, as well as non-intact skin and mucous membranes. Essentially, both standard and 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 standard precautions for patients who are known or suspected to have an infectious conditions, 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
Eyewear (goggles or glasses)
Face shields
Hair nets
Shoe coverings

[edit] See also
Body substance isolation
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Category: Medical hygiene

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