Body substance isolation
Encyclopedia
Body substance isolation is a practice of isolating all body substances (blood
, urine
, feces
, tears
, etc.) of individuals undergoing medical treatment, particularly emergency medical treatment of those who might be infected with illnesses such as HIV
, or hepatitis
so as to reduce as much as possible the chances of transmitting these illnesses. BSI is similar in nature to universal precautions
, but goes further in isolating workers from pathogens, including substances now known to carry HIV.
Body substance isolation went further than universal precautions
in isolating workers from pathogens, including substances now currently known to carry HIV
. These pathogens fall into two broad categories, bloodborne (carried in the body fluids) and airborne. The practice of BSI was common in Pre-Hospital care and Emergency Medical Services
due to the often unknown nature of the patient and his/her disease or medical conditions. It was a part of the National Standards Curriculum for Prehospital Providers and Firefighters.
Types of body substance isolation included:
It was postulated that BSI precautions should be practiced in environment where treaters were exposed to bodily fluids, such as:
Such infection control techniques that were recommended following the AIDS
outbreak in the 1980s. Every patient was treated as if infected and therefore precautions were taken to minimize risk. Other conditions which called for minimizing risks with BSI:
or any combination of the above.
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
, urine
Urine
Urine is a typically sterile liquid by-product of the body that is secreted by the kidneys through a process called urination and excreted through the urethra. Cellular metabolism generates numerous by-products, many rich in nitrogen, that require elimination from the bloodstream...
, feces
Feces
Feces, faeces, or fæces is a waste product from an animal's digestive tract expelled through the anus or cloaca during defecation.-Etymology:...
, tears
Tears
Tears are secretions that clean and lubricate the eyes. Lacrimation or lachrymation is the production or shedding of tears....
, etc.) of individuals undergoing medical treatment, particularly emergency medical treatment of those who might be infected with illnesses such as HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
, or hepatitis
Hepatitis
Hepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...
so as to reduce as much as possible the chances of transmitting these illnesses. BSI is similar in nature to universal precautions
Universal precautions
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. The practice was introduced in 1985–88. In 1987, the practice of universal precautions was...
, but goes further in isolating workers from pathogens, including substances now known to carry HIV.
Place of body substance isolation practice in history
Practice of Universal precautions was introduced in 1985–88. In 1987, the practice of Universal precautions was adjusted by a set of rules known as body substance isolation. In 1996, both practices were replaced by the latest approach known as standard precautions (health care). Nowadays and in isolation, practice of body substance isolation has just historical significance.Body substance isolation went further than universal precautions
Universal precautions
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. The practice was introduced in 1985–88. In 1987, the practice of universal precautions was...
in isolating workers from pathogens, including substances now currently known to carry HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
. These pathogens fall into two broad categories, bloodborne (carried in the body fluids) and airborne. The practice of BSI was common in Pre-Hospital care and Emergency Medical Services
Emergency medical services
Emergency medical services are a type of emergency service dedicated to providing out-of-hospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency...
due to the often unknown nature of the patient and his/her disease or medical conditions. It was a part of the National Standards Curriculum for Prehospital Providers and Firefighters.
Types of body substance isolation included:
- Hospital gownHospital gownA hospital gown, also known as a patient gown, exam gown, johnny shirt or johnny gown, is a short-sleeved, thigh-length garment worn by patients in hospitals and other medical facilities.-Utility:...
s - Medical glovesMedical glovesMedical gloves are disposable gloves used during medical examinations and procedures that help prevent contamination between caregivers and patients. Medical gloves are made of different polymers including latex, nitrile rubber, vinyl and neoprene; they come unpowdered, or powdered with cornstarch...
- Shoe covers
- Surgical maskSurgical maskA surgical mask also known as a procedure mask is intended to be worn by health professionals during surgery and at other times to catch the bacteria shed in liquid droplets and aerosols from the wearer's mouth and nose....
or N95 RespiratorRespiratorA respirator is a device designed to protect the wearer from inhaling harmful dusts, fumes, vapors, or gases. Respirators come in a wide range of types and sizes used by the military, private industry, and the public... - Safety GlassesGlassesGlasses, also known as eyeglasses , spectacles or simply specs , are frames bearing lenses worn in front of the eyes. They are normally used for vision correction or eye protection. Safety glasses are a kind of eye protection against flying debris or against visible and near visible light or...
It was postulated that BSI precautions should be practiced in environment where treaters were exposed to bodily fluids, such as:
- bloodBloodBlood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
, semenSemenSemen is an organic fluid, also known as seminal fluid, that may contain spermatozoa. It is secreted by the gonads and other sexual organs of male or hermaphroditic animals and can fertilize female ova...
, preseminal fluid, vaginal secretions, synovial fluidSynovial fluidSynovial fluid is a viscous, non-Newtonian fluid found in the cavities of synovial joints. With its yolk-like consistency , the principal role of synovial fluid is to reduce friction between the articular cartilage of synovial joints during movement.-Overview:The inner membrane of synovial joints...
, amniotic fluidAmniotic fluidAmniotic fluid or liquor amnii is the nourishing and protecting liquid contained by the amniotic sac of a pregnant woman.- Development of amniotic fluid :...
, cerebrospinal fluidCerebrospinal fluidCerebrospinal fluid , Liquor cerebrospinalis, is a clear, colorless, bodily fluid, that occupies the subarachnoid space and the ventricular system around and inside the brain and spinal cord...
, pleural fluid, peritoneal fluidPeritoneal fluidPeritoneal fluid is a liquid that is made in the abdominal cavity to lubricate the surface of the tissue that lines the abdominal wall and pelvic cavity and covers most of the organs in the abdomen.- External links :...
, marrowBone marrowBone marrow is the flexible tissue found in the interior of bones. In humans, bone marrow in large bones produces new blood cells. On average, bone marrow constitutes 4% of the total body mass of humans; in adults weighing 65 kg , bone marrow accounts for approximately 2.6 kg...
, pericardial fluidPericardial fluidSurrounding the heart is a sac known as the pericardium, which consists of two membranes. The outer layer being the fibrous parietal pericardium and the inner layer being the serous visceral pericardium. It is the serous visceral pericardium that secretes the pericardial fluid into the pericardial...
, fecesFecesFeces, faeces, or fæces is a waste product from an animal's digestive tract expelled through the anus or cloaca during defecation.-Etymology:...
, nasal secretions, urineUrineUrine is a typically sterile liquid by-product of the body that is secreted by the kidneys through a process called urination and excreted through the urethra. Cellular metabolism generates numerous by-products, many rich in nitrogen, that require elimination from the bloodstream...
, vomitus, sputumSputumSputum is mucus that is coughed up from the lower airways. It is usually used for microbiological investigations of respiratory infections....
, mucusMucusIn vertebrates, mucus is a slippery secretion produced by, and covering, mucous membranes. Mucous fluid is typically produced from mucous cells found in mucous glands. Mucous cells secrete products that are rich in glycoproteins and water. Mucous fluid may also originate from mixed glands, which...
, cervical mucus, phlegmPhlegmPhlegm is a liquid secreted by the mucous membranes of mammalians. Its definition is limited to the mucus produced by the respiratory system, excluding that from the nasal passages, and particularly that which is expelled by coughing . Phlegm is in essence a water-based gel consisting of...
, salivaSalivaSaliva , referred to in various contexts as spit, spittle, drivel, drool, or slobber, is the watery substance produced in the mouths of humans and most other animals. Saliva is a component of oral fluid. In mammals, saliva is produced in and secreted from the three pairs of major salivary glands,...
, breastmilk, colostrumColostrumColostrum is a form of milk produced by the mammary glands of mammals in late pregnancy. Most species will generate colostrum just prior to giving birth...
, and secretions and blood from the umbilical cordUmbilical cordIn placental mammals, the umbilical cord is the connecting cord from the developing embryo or fetus to the placenta...
Such infection control techniques that were recommended following the AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
outbreak in the 1980s. Every patient was treated as if infected and therefore precautions were taken to minimize risk. Other conditions which called for minimizing risks with BSI:
- Diseases with air-borne transmission (e.g., tuberculosisTuberculosisTuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
) - Diseases with droplet transmission (e.g., mumpsMumpsMumps is a viral disease of the human species, caused by the mumps virus. Before the development of vaccination and the introduction of a vaccine, it was a common childhood disease worldwide...
, rubellaRubellaRubella, commonly known as German measles, is a disease caused by the rubella virus. The name "rubella" is derived from the Latin, meaning little red. Rubella is also known as German measles because the disease was first described by German physicians in the mid-eighteenth century. This disease is...
, influenzaInfluenzaInfluenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals...
, pertussisPertussisPertussis, also known as whooping cough , is a highly contagious bacterial disease caused by Bordetella pertussis. Symptoms are initially mild, and then develop into severe coughing fits, which produce the namesake high-pitched "whoop" sound in infected babies and children when they inhale air...
) - Transmission by direct or indirect contact with dried skin (e.g., colonisation with MRSAMethicillin-resistant Staphylococcus aureusMethicillin-resistant Staphylococcus aureus is a bacterium responsible for several difficult-to-treat infections in humans. It is also called multidrug-resistant Staphylococcus aureus and oxacillin-resistant Staphylococcus aureus...
) or contaminated surfaces - PrionPrionA prion is an infectious agent composed of protein in a misfolded form. This is in contrast to all other known infectious agents which must contain nucleic acids . The word prion, coined in 1982 by Stanley B. Prusiner, is a portmanteau derived from the words protein and infection...
diseases (e.g., Creutzfeldt-Jakob diseaseCreutzfeldt-Jakob diseaseCreutzfeldt–Jakob disease or CJD is a degenerative neurological disorder that is incurable and invariably fatal. CJD is at times called a human form of mad cow disease, given that bovine spongiform encephalopathy is believed to be the cause of variant Creutzfeldt–Jakob disease in humans.CJD...
)
or any combination of the above.