Standard Precautions

6 10 2006

How do we avoid infections?  Without rolling around in a plastic bubble spraying the world with disinfectant, we can’t avoid all of them, nor would we want to.  Some germs are good for us, as we are for them, and we form a mutualistic relationship with each other, meaning both organisms, although different from each other, live in close association to their mutual benefit.

Too much biology, right?  Let’s get to the good stuff, where we find out how to stay (almost) infection-free and still live normal lives.

There are four steps we can take to help keep ourselves and our loved ones healthy:
• Wash hands a lot (http://www.pkids.org/infection_protection.php)
• Get immunized (http://www.pkids.org/immunizations.php)
• Disinfect our work and home areas (http://www.pkids.org/pdf/idw/text21.pdf)
• Practice standard precautions (http://www.pkids.org/pdf/idw/text21.pdf)

Today we’re focusing on standard precautions.  For practical purposes in daily living, standard precautions means assuming that every person’s blood and body fluids are infectious for HIV, hepatitis B virus (HBV), and other bloodborne pathogens.

The safest way to go about living these days is to assume everyone is infected with something. People of all colors, rich and poor, fat and thin, old and young are chronically infected with hepatitis C virus (HCV), HBV, HIV, and other diseases. Forty to 90 percent of these folks don’t know they’re infected.

It’s impossible to identify all those living with an infectious disease. The only way to try and keep ourselves and our families reasonably safe is to learn a practical approach to standard precautions. At first, paranoia of everyone and everything is common, but eventually the precautions become habits—like turning the lock on a door, or stepping on the brake at a red light. They become normal, daily precautions.

The primary thing to remember with standard precautions is to always have a barrier between our skin and mucous membranes (around the eyeballs, gums, and inside the nose), and the (potentially) infectious substance. Go to a medical supply store and buy some latex gloves. Keep them in the house and car.  If there are no gloves around and we need to deal with someone’s body fluid, we can put sandwich baggies or trash can liners over our hands.  We can also use a sanitary napkin or thick, rolled-up towel to collect the fluid or staunch the flow of blood.

Keep prescription glasses on to protect the eyes (and to see what’s happening) or put on sunglasses.  A scarf can be tied around the face, like the masked bandits used to do, to protect the nose and mouth. 

Use a one-part bleach to ten-part water solution, or another disinfectant for cleaning up substances. Including our own! As soon as the clean-up is done, throw away the disposable protective items (gloves, etc.) and wash hands thoroughly.

As soon as possible, cover the hands again and remove any non-disposable clothing and wash it appropriately. Common sense guides us in this. We don’t want to go through all of the precautions only to bare hand our pants which are covered in someone else’s body fluid.

Make sure all cuts and abrasions covered with a waterproof bandage. Be careful with badly chapped skin. It can crack and allow fluids to enter and exit. These precautions are a two-way street. We may be some of the millions unaware that we’re living with an infectious disease.

Only a parent knows if a child is old enough to understand these precautions. Practicing them with our kids would be useful for the whole family. If the kids are too young to understand what we’ve outlined, there are a few things we can try to help the younger members of the family participate in standard precautions.

Set aside a non-work day to role-play this with the kids. Call it “Family Safety Day.” This would also be a good day to practice evacuating the house in case of fire and all those other safety rules we seldom rehearse.

First, remember to keep the kids’ cuts covered with a bandage which won’t let anything in or out. To help the kids understand how invisible germs can pass from one person to the next, put glitter on a child’s hands and let him/her go to the bathroom, play with family members, and pick up a cracker (without actually eating it). Go back to the beginning of the journey and walk him/her around the house, following the trail of glitter. This will help demonstrate how we can pass germs (and other things) to each other without knowing it. To press home the point, we should put glitter on our hands, too.

Have one member of the family be “bleeding” ketchup. Pretend to be a young child and run for an adult when the “blood” is visible.  Have a young child go through the same scenario several times.  Then pretend there’s no adult around and show the children how to use a coat or towel as a barrier between them and the blood.

It’s important that kids learn not to reach out and touch another person’s blood or body fluid. One way to help them understand (and this is kind of gross) is to ask them if they would touch someone else’s poop or nose gunk. Most kids, no matter how young, will say no. Once we get that all important “no”, explain that blood is really personal and they don’t want to touch anyone else’s blood.

This approach is necessary only for a few years. Once they get to be five or six, we can start explaining more.

A few general rules for everyone to remember would be: don’t share razors, toothbrushes, manicure tools, nail clippers, hypodermic needles, cocaine straws, body piercing equipment, tattooing equipment—anything that can puncture and/or is a personal grooming item.

Standard precautions as practiced by healthcare professionals cover a wide range of topics, including sharps disposal, ventilation devices (mouth pieces for resuscitation), specimen handling, and other opportunities for the spread of infection which we’re unlikely to come across in daily living.

Today’s tips are meant to be a more practical approach for everyday living.

 


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