Universal precautions
Encyclopedia
Universal precautions refers to the practice, in medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

, of avoiding contact with patients' bodily fluids, by means of the wearing of nonporous articles such as medical gloves
Medical gloves
Medical 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...

, goggles
Goggles
Goggles or safety glasses are forms of protective eyewear that usually enclose or protect the area surrounding the eye in order to prevent particulates, water or chemicals from striking the eyes. They are used in chemistry laboratories and in woodworking. They are often used in snow sports as well,...

, and face shield
Face shield
A face shield is a device used to protect wearer's entire face from impact hazard such as flying objects and road debris, chemical splashes , or potentially infectious fluid .-Industry:...

s. The practice was introduced in 1985–88. In 1987, the practice of universal precautions was adjusted by a set of rules known as body substance isolation
Body substance isolation
Body substance isolation is a practice of isolating all body substances 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...

. In 1996, both practices were replaced by the latest approach known as standard precautions (health care). Nowadays and in isolation, practice of universal precautions has historical significance.

Historical significance of universal precautions

Under universal precautions all patients were considered to be possible carriers of blood-borne pathogens. The guideline recommended wearing gloves when collecting or handling blood and body fluids contaminated with blood, wearing face shields when there was danger of blood splashing on mucous membranes and disposing of all needles and sharp objects in puncture-resistant containers.

Universal precautions were designed for doctors, nurses, patients, and health care support workers who were required to come into contact with patients or bodily fluids. This included staff and others who might not come into direct contact with patients.

Pathogens fall into two broad categories, bloodborne (carried in the body fluids) and airborne.

Use

Universal precautions were typically practiced in any environment where workers were exposed to bodily fluids, such as:
  • Blood
    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....

  • Semen
    Semen
    Semen 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...

  • Vaginal secretions
  • Synovial fluid
    Synovial fluid
    Synovial 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 fluid
    Amniotic fluid
    Amniotic fluid or liquor amnii is the nourishing and protecting liquid contained by the amniotic sac of a pregnant woman.- Development of amniotic fluid :...

  • Cerebrospinal fluid
    Cerebrospinal fluid
    Cerebrospinal 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 fluid
    Peritoneal fluid
    Peritoneal 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 :...

  • Pericardial fluid
    Pericardial fluid
    Surrounding 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...



Bodily fluids that did not require such precautions included:
  • 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:...

  • Nasal secretions
  • 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...

  • Vomitus
  • Perspiration
  • Sputum
    Sputum
    Sputum is mucus that is coughed up from the lower airways. It is usually used for microbiological investigations of respiratory infections....

  • Saliva
    Saliva
    Saliva , 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,...



Universal precautions were the 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.

Essentially, universal precautions were good hygiene habits, such as hand washing and the use of gloves and other barriers, correct handling of hypodermic needle
Hypodermic needle
A hypodermic needle is a hollow needle commonly used with a syringe to inject substances into the body or extract fluids from it...

s and scalpel
Scalpel
A scalpel, or lancet, is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, and various arts and crafts . Scalpels may be single-use disposable or re-usable. Re-usable scalpels can have attached, resharpenable blades or, more commonly, non-attached, replaceable...

s, and aseptic techniques.

Equipment

Protective clothing included but was not limited to:
  • Barrier gowns
  • Gloves
  • Eyewear
    Eyewear
    Eyewear can refer to:*Glasses *Sunglasses*Contact lenses*Eye protection**Goggles...

     (goggles
    Goggles
    Goggles or safety glasses are forms of protective eyewear that usually enclose or protect the area surrounding the eye in order to prevent particulates, water or chemicals from striking the eyes. They are used in chemistry laboratories and in woodworking. They are often used in snow sports as well,...

     or glasses
    Glasses
    Glasses, 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...

    )
  • Face shield
    Face shield
    A face shield is a device used to protect wearer's entire face from impact hazard such as flying objects and road debris, chemical splashes , or potentially infectious fluid .-Industry:...

    s

Additional precautions

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

Conditions indicating additional precautions:
  • Prion
    Prion
    A 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 disease
    Creutzfeldt-Jakob disease
    Creutzfeldt–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...

    )
  • Diseases with air-borne transmission (e.g., tuberculosis
    Tuberculosis
    Tuberculosis, 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., mumps
    Mumps
    Mumps 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...

    , rubella
    Rubella
    Rubella, 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...

    , influenza
    Influenza
    Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals...

    , pertussis
    Pertussis
    Pertussis, 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 MRSA
    Methicillin-resistant Staphylococcus aureus
    Methicillin-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 or any combination of the above.

Issues of stigma and discrimination

Research around stigma and discrimination in health-related settings has implicated universal precautions as a means by which health care workers discriminate against patients . Particularly the employment of universal precautions when working with people with HIV and/or hepatitis C has been demonstrated to be inconsistent and implicated with feelings of stigmatization reported by those populations . Health-cased social research reveals that by not applying universal precautions universally, as is the purpose, health professionals are instead making judgements based on an individual's health status . It is speculated that this differential approach to care stems from stigma towards HIV and hepatitis C, rooted largely in fears and misconceptions around transmission and assumptions about patient lifestyle and risk.

External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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