Universal Precautions

"Universal precautions," as defined by CDC, are a set of precautions designed to prevent transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and other blood borne pathogens when providing first aid or health care. Under universal precautions, blood and certain body fluids of all patients are considered potentially infectious for HIV, HBV and other blood borne pathogens.

Universal precautions apply to blood, other body fluids containing visible blood, semen, and vaginal secretions. Universal precautions also apply to tissues and to the following fluids: cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids. Universal precautions do not apply to feces, nasal secretions, sputum, sweat, tears, urine, and vomitus unless they contain visible blood. Universal precautions do not apply to saliva except when visibly contaminated with blood or in the dental setting where blood contamination of saliva is predictable.

Universal precautions involve the use of protective barriers such as gloves, gowns, aprons, masks, or protective eyewear, which can reduce the risk of exposure of the health care worker's skin or mucous membranes to potentially infective materials. In addition, under universal precautions, it is recommended that all health care workers take precautions to prevent injuries caused by needles, scalpels, and other sharp instruments or devices. Infection control is an important and ongoing concern in HIV programs.

HIV transmission: in addition to the risk of infection from sexual contact, HIV can be transmitted through transfusion with HIV-infected blood or blood products, or from a needle stick injury involving a needle used by an HIV-infected person. The most common form of transmission of HIV by needles occurs when persons using illegal injecting drugs share needles. It is also possible to become infected when infected blood, or a bodily fluid containing infected blood, comes in contact with mucous membranes or skin that is broken or open. Universal precautions have been recommended for anyone who might come in contact with blood or body fluids.

Hand washing: Hand washing is the cornerstone of infection control. Good practice mandates that staff members always wash their hands

After using the toilet.
After helping a child with toileting or diapering.
After wiping runny noses.
When preparing to assist with eating or feeding.
After accidental contact with blood or blood-tinged fluids.

As protection against the blood-related modes of transmission, health and child care workers should use universal precautions when coming in contact with the blood of all clients, or bodily fluids containing blood.

Health care persons/workers should adhere to the following universal precautions:

If you have cuts or other abrasions then cover them with a waterproof plaster.
Mop up blood spills using gloves and paper towels and wash with either detergent or a chlorine solution made from NaDCC (sodium dichloroisocyanurate) tablets. For large spillages NaDCC granules should be available. An alternative is to use a 1% solution of sodium hypochlorite.
'Spill Kits' containing the above items may also be available in some districts for use in the community. In instances where NaDCC tablets are not available, diluted household bleach should be used.
In hospital settings all linen with blood on it should be sealed in a water-soluble bag. This should then be placed in a red marked bag and labeled according to hospital procedures. Linen contaminated in the community should be washed on a hot wash cycle (approx. 70 degrees). If a machine is not available, contact should be made with the Infection Control Department.
In domestic settings pads, sanitary wear and disposable nappies should be (double) wrapped in polythene bags and put in a lidded bin away from children, or put in an incinerator where available. Hands should be washed before and after changing nappies, or disposable gloves should be used.
Terry nappies and protective plastic pants should be washed as normal (soaked in a bucket with nappy cleanser, rinsed and washed with hot water and detergent).
Wear latex gloves when coming into contact with blood, skin and mucous membrane cuts, or any open skin lesion.
Use gloves only for the care of one child, then discard the gloves.
Wash hands after discarding the gloves.
Properly dispose of contaminated materials exposed to blood, such as needles.
Strict adherence to universal precautions prevents exposure to blood-borne pathogens including HIV and hepatitis B.

Nasal secretions, saliva, sputum, sweat, tears, urine, vomitus, and feces are not implicated in the transmission of HIV unless they contain visible blood. Gloves are not necessary for diaper changing unless the health or child care worker has open skin lesions or the child has diarrhea or visible blood in the stool. Casual contact between infected and uninfected individuals does not transmit HIV.