When people hear the phrase “bloodborne infectious diseases,” they might think this is something only scientists who work in an infectious disease lab have to be concerned about.
But protection against bloodborne pathogens is important for a wide range of professionals, from tattooists, piercers, first responders, maintenance workers, and healthcare workers. And even if you’re a bystander witnessing a health emergency, you might need to know how to protect yourself against contamination.
This is where universal safety precautions come in. They’re a set of guidelines to help control the transmission of disease. These precautions focus on blood and a few other fluids, but they’ve paved the way for stronger guidelines as well.
Let me walk you through the basics of when to use universal precautions and what they entail.
The Origins of Universal Precautions
Safety and hygiene have been important elements in the medical field ever since people first learned of contamination. But it wasn’t until 1985 that the Centers for Disease Control and Prevention (the CDC) introduced a set of explicit safety guidelines called universal precautions.
This happened in response to the HIV epidemic of the time, which could be spread from person to person through fluids. Universal precautions, then, focused on controlling the transmission of diseases spread by bodily fluids like blood.
These days, there is also the concept of “standard precautions,” which cover even more situations than universal precautions. But whether a person is following standard precautions or universal precautions, they will use many of the same basic measures.
Though universal precautions training is quite comprehensive, it’s now less comprehensive than other guidelines like standard precautions or field-specific precautions. This doesn’t mean it’s fallen out of relevance, though. It’s just more of an entry point into the modern world of safety guidelines.
In fact, stronger sets of guidelines often build off of universal precautions. So whichever set of guidelines people follow, they will likely have to learn about universal precautions at some point.
When to Use Universal Safety Precautions
Bloodborne pathogens like HIV and Hepatitis B raise the risk level higher than normal. When someone doesn’t know whether these risks are present or not, it’s good practice to treat all blood as if it contains these pathogens. This is what I mean by universal precautions.
Universal precautions for infection control have to do with blood and certain fluids like cerebrospinal fluid or semen. They do not apply to other fluids like sweat or urine unless those fluids are visibly contaminated with blood.
And though the precautions don’t apply to unbroken skin, it might be hard for a medical provider or first responder to know whether there are small breaks in the skin. What it comes down to is whether there’s a possible risk of infection through blood.
Universal precautions include a mix of common-sense guidelines, like hand washing, and specialized gear, like personal protective equipment. Together, these provide multiple levels of barriers against contamination by blood or certain other fluids.
Personal Protective Equipment (PPE)
Ever since the spread of COVID-19, the term “PPE” has gone from a specialized term to everyday vocabulary. People understand that special pieces of equipment like masks and gloves are important to reduce transmission of a virus.
But PPE has been around for a while, and it’s an important step for universal precautions against any type of pathogen, virus or not.
Medical professionals and first responders often have some kind of PPE handy. They know they’ll need to use universal safety precautions quite regularly. For people administering first aid or bystanders, though, PPE might be hard to find.
This is why it’s a good idea to include PPE in first aid kits in the first place—you never know when you’re going to need it.
In order to follow universal precautions, it’s not enough to just own and use the protective gear. People need to be able to use the gear correctly. Here, let’s talk about one of the most common and visible aspects of safety precautions: gloves.
Some people who are new to universal precautions or who are having an absent-minded moment might take off their gloves by pulling from the fingertips. Not only does this make the glove stick to their hand more—it is not an example of proper universal precautions.
The correct, sanitary way to remove gloves is to pull up from the base of the glove (around the wrist), turning the glove inside out along the way. This way, there is no threat of contact between bare skin and the outside of the glove.
In fact, this inside-out maneuver is good practice not just for gloves but for anything people might wear in a high-risk situation. Turning protective clothes inside out during removal is an excellent way to keep hazardous substances away from human contact.
Decontamination, Not Just Cleaning
When people know they are going to work near human fluids, they know cleaning is important. But when they follow universal safety precautions, the level of cleaning has to match the assumed risk level.
People who use universal precautions have to decontaminate surfaces after every use. This means they need to use cleaning products that kill pathogens. It’s not enough to just stop the spread of spills—remember that universal precautions treat all fluids as if they were infectious.
If there’s been a spill involving blood, the first step is to clean up the spill using protective barriers and PPE. The next step is to immediately decontaminate any area that might be affected.
Labs and medical facilities have special receptacles for disposing of things like needles. This is for a few reasons.
First, exposure to these items has the potential to spread infection. If someone disposes of a contaminated needle in a regular, open trash bin and then accidentally brushes by it later, they can spread infectious fluids. Safe receptacles have closed lids and are clearly marked so people know to be cautious around them.
In addition, items like needles are quite sharp and may break through the skin of a healthy person, infecting them. And even if the needles aren’t contaminated, the risk of minor injury is still something people want to avoid.
And then there is the concept of immediate disposal. As I describe in the next section, needles are examples of things that should be tossed out and replaced after every use. When there’s a special receptacle, people don’t have to carry needles around until they find a proper way to dispose of them.
Special disposable bins aren’t always available—for example, in a health emergency on the street. For this reason, universal precautions call on people to treat all trash at the scene as if it contains sharp items like needles.
Things to Change Out After Every Use
I’ve gone over decontamination after every use, but sometimes even this level of cleaning is not enough. There are many circumstances where it’s better to dispose of a material and get a replacement.
Some examples include gloves and disposable masks. And if a patient or subject is using any kind of barrier between them and a surface (like a table or seat), these are usually changed out after every use.
This isn’t always obvious, so it’s an important piece of universal precautions to learn about. While it would seem unsanitary to use the same needle twice, other items like barriers and coverings are less intuitive. Special professions that put workers at risk of bloodborne pathogens, like the body art field, need to prepare for business by knowing which pieces of their equipment are single-use only.
Like PPE, hand washing has been on many people’s minds since the start of the coronavirus pandemic. And like PPE, this is a practice that people should follow even when there isn’t a widespread pandemic to watch out for.
Universal precautions provide routine protection against deadly diseases. While some aspects of these precautions require special gear, hand washing is an example of something everyone can do. If someone does happen to come into contact with a pathogen, hand washing prevents that pathogen from entering the body.
Hand washing is an important step even if someone is wearing gloves or using other protective barriers in their work. Once people take their gloves off, they can get straight to washing their hands.
The nice thing about universal precautions is that they build in plenty of redundant measures for additional safety. Even if a mistake happens somewhere along the way, there is still a high level of protection.
Better Safe Than Sorry
Universal safety precautions are an excellent thing to learn for anyone who’s trying to learn the guidelines in their workplace. And they can also be great resources for bystanders and people administering first aid.
Staying safe might seem like an overwhelming task, but it doesn’t have to be. As long as people follow straightforward guidelines like universal precautions, they’ll be well-equipped for whatever lies ahead.
And when reading the information isn’t enough, there are video courses and trainings. Here at HIPAA Exams, we have special training bundles like the HIPAA and OSHA bloodborne pathogens bundle for healthcare workers.