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 illnessess 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 not currently known to carry HIV. These pathogens fall into two broad categories, bloodborne (carried in the body fluids) and airborne. This practice is 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 is part of the National Standards Curriculum for Prehospital Providers and Firefighters.

Types of Body Substance Isolation include:

• Hospital gowns
• Medical gloves
• Shoe covers
• Surgical mask or N95 Respirator
• Safety Glasses

BSI precautions should be practiced in environment where treaters are exposed to bodily fluids, such as:

• Blood, Semen, Vaginal secretions, Synovial fluid, Amniotic fluid, Cerebrospinal fluid, Pleural fluid, Peritoneal fluid, Pericardial fluid, Feces, Nasal secretions, Urine, Vomitus, Sputum, Saliva

Such infection control techniques that were recommended following the AIDS outbreak in the 1980s. Every patient is treated as if infected and therefore precautions are taken to minimize risk. Other conditions which call for minimizing risks with BSI:

• Diseases with air-borne transmission (e.g., tuberculosis)
• Diseases with droplet transmission (e.g., mumps, rubella, influenza, pertussis)
• Transmission by direct or indirect contact with dried skin (e.g., colonisation with MRSA) or contaminated surfaces
• Prion diseases (e.g., Creutzfeldt-Jakob disease)

or any combination of the above.

[edit] References

• Standard Precautions excerpt from the Guideline for Isolation Standard Precautions

• Guidelines for Isolation Precautions in Hospitals

• Practices (ie, use of gloves/masks/gowns) and compliance with upgraded containment/disposal measures

• History of Infection Control Precautions Powerpoint Presentation

• Section III Principles of Biosafety Standard Precautions, ”to synthesize the major features of Universal Precautions (blood and body fluid) with Body Substance Isolation Precautions..."

• Recommendations for Prevention of HIV Transmission in Health-Care Settings

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