Infection prevention and control (IPC) is essential during basic life support (BLS) and CPR. To prevent infection, rescuers should follow standard precautions, practice proper hand hygiene, use appropriate personal protective equipment (PPE), and use barrier devices when providing rescue breaths. These steps help reduce the risk of spreading bloodborne pathogens and other infectious microorganisms between the rescuer and patient.
This guide explains how to prevent infection during BLS, CPR, and first aid, including standard precautions, aseptic technique, PPE, hand hygiene, equipment cleaning and disinfection, and what to do after blood or body fluid exposure.
How to Prevent Infection?
To prevent infection during BLS, CPR, and first aid, follow standard infection prevention and control (IPC) practices. Key steps include:
- Practice hand hygiene. Clean your hands before and after patient contact and after removing gloves. Use soap and water or an alcohol-based hand sanitizer when appropriate.
- Use personal protective equipment (PPE). Wear gloves and use eye, face, or other protection when contact with blood, body fluids, or other potentially infectious materials is expected.
- Follow standard precautions. Treat blood and certain body fluids as potentially infectious and use precautions based on the expected exposure.
- Use aseptic technique when required. Keep procedures, equipment, and supplies free from contamination when performing tasks that require asepsis.
- Use a barrier device for rescue breaths. When providing rescue breathing, use an appropriate barrier device, such as a pocket mask or bag-valve-mask (BVM), according to your training and available equipment.
- Clean and disinfect reusable equipment. Follow the manufacturer's instructions and the disinfectant's label for proper use and contact time.
- Handle blood and body fluids safely. Avoid direct contact and safely clean and dispose of contaminated materials.
- Follow sharps safety practices. Do not recap, bend, or manipulate used needles or other contaminated sharps unless required by a specific procedure.
- Follow respiratory hygiene and cough etiquette. Use appropriate measures to reduce the spread of respiratory infections.
- Follow transmission-based precautions when indicated. Additional precautions, such as contact precautions, may be required for patients with certain infectious conditions or multidrug-resistant organisms (MDROs).
These practices form the foundation of infection prevention and control and help reduce the risk of transmitting infections during patient care.
What Is Infection Prevention and Control (IPC)?
Infection prevention and control (IPC) is a set of practices used to prevent and reduce the spread of infections in healthcare and patient-care settings. IPC protects patients, healthcare workers, rescuers, and others from exposure to infectious microorganisms.
In basic life support, CPR, and first aid, infection prevention focuses on practical measures such as hand hygiene, personal protective equipment (PPE), standard precautions, safe handling of blood and body fluids, proper cleaning and disinfection, and the use of barrier devices during rescue breathing.
Principles of Infection Prevention and Control
The basic principles of IPC include:
- Hand hygiene: Clean your hands at the appropriate times to reduce the spread of microorganisms.
- Risk assessment: Identify potential exposure to blood, body fluids, respiratory secretions, or other infectious materials before providing care.
- PPE: Select gloves, gowns, masks, and eye or face protection based on the expected exposure.
- Aseptic technique: Use practices that prevent contamination when performing procedures that require asepsis.
- Respiratory hygiene: Follow measures that reduce the spread of respiratory infections.
- Safe equipment handling: Clean, disinfect, or reprocess reusable equipment according to manufacturer instructions.
- Safe waste and sharps handling: Dispose of contaminated materials and sharps safely.
- Transmission-based precautions: Use additional precautions when indicated for specific infectious conditions.
Following these principles helps create a safer environment for both the person receiving care and the person providing it.
What are Standard Precautions in Infection Control?
Standard Precautions are the basic infection prevention practices used for every patient, regardless of whether an infection is known or suspected. They are based on the risk of exposure to blood, body fluids, respiratory secretions, non-intact skin, and other potentially infectious materials.
During BLS, CPR, and first aid, standard precautions help protect both the rescuer and the patient from infection. Standard Precautions include:
- Hand hygiene: Clean your hands before and after patient contact and after removing gloves.
- Personal protective equipment (PPE): Wear gloves, masks, eye protection, gowns, or other PPE when exposure is expected.
- Respiratory hygiene and cough etiquette: Use appropriate measures to reduce the spread of respiratory infections.
- Safe handling of blood and body fluids: Avoid unnecessary contact with potentially infectious materials.
- Sharps safety: Handle and dispose of contaminated sharps safely.
- Safe injection practices: Use safe practices when preparing or administering injections.
- Environmental cleaning: Clean and disinfect surfaces and equipment that may be contaminated.
- Equipment reprocessing: Properly clean, disinfect, or sterilize reusable equipment according to its intended use and manufacturer instructions.
- Waste handling: Dispose of contaminated waste according to applicable procedures.
Why Are Standard Precautions Important?
Standard Precautions help reduce the risk of infection transmission even when a patient's infection status is unknown. They provide a consistent approach to infection control during patient care and are a foundation of infection prevention and control.
For BLS and first aid providers, the most relevant practices include hand hygiene, appropriate PPE, barrier devices for rescue breathing, safe handling of blood and body fluids, and proper cleaning and disinfection of reusable equipment.
Hand Hygiene
Hand hygiene is one of the most important ways to prevent the spread of infection. Clean your hands before and after patient care and after removing gloves. Good hand hygiene helps reduce the transfer of microorganisms from your hands to patients, equipment, and surfaces.
When to Clean Your Hands?
Perform hand hygiene:
- Before and after providing patient care
- After removing gloves
- After contact with blood, body fluids, or contaminated materials
- After touching contaminated equipment or surfaces
- Before handling clean or sterile supplies
- Whenever your hands are visibly dirty
How to Clean Your Hands?
Use soap and water when your hands are visibly dirty or when otherwise indicated by your setting's infection-control procedures. Wet your hands, apply soap, rub all hand surfaces thoroughly, rinse, and dry with a clean towel.
Use an alcohol-based hand sanitizer when your hands are not visibly dirty and hand sanitizer is appropriate for the situation. Apply enough product to cover all hand surfaces and rub your hands together until they are completely dry.
Does Wearing Gloves Replace Hand Hygiene?
No. Gloves do not replace hand hygiene. Clean your hands before putting on gloves and after removing them. Change gloves between patients and whenever they become contaminated or damaged.
Hand hygiene is a basic infection-control practice that should be combined with PPE, standard precautions, proper equipment cleaning, and other IPC measures.
What Is Aseptic Technique?
Aseptic technique is a set of practices used to prevent the introduction and spread of microorganisms during procedures that require protection from contamination. It involves maintaining a clean or aseptic environment, using appropriate equipment and supplies, practicing hand hygiene, and preventing contact with potentially contaminated surfaces or materials.
Aseptic technique is an important part of infection prevention and control in healthcare and patient-care settings. The basic principles of proper aseptic technique include:
- Perform hand hygiene before starting an aseptic procedure.
- Prepare a clean work area and remove unnecessary items that can cause contamination.
- Use clean or sterile equipment when required for the procedure.
- Avoid touching critical parts of equipment, supplies, or sterile items.
- Use appropriate PPE based on the expected exposure and procedure.
- Keep clean and contaminated items separate.
- Maintain asepsis throughout the procedure and replace any item that becomes contaminated.
- Clean and disinfect surfaces and reusable equipment according to established procedures and manufacturer instructions.
Aseptic Technique vs. Sterile Technique
Aseptic and sterile techniques both help prevent contamination, but they are not identical.
Aseptic technique focuses on preventing the introduction and spread of harmful microorganisms during a procedure. Sterile technique uses practices designed to maintain an area or item free from all microorganisms.
The technique required depends on the procedure, patient-care setting, and level of contamination risk.
What Is Aseptic Technique in Nursing?
In nursing, aseptic technique is used during procedures where preventing contamination is important for patient safety. Examples include wound care, inserting certain medical devices, handling sterile supplies, and other procedures that require an aseptic approach.
The specific technique and level of asepsis should follow the healthcare facility's policies, applicable infection-control guidelines, and the manufacturer's instructions for equipment and supplies.
How to Prevent Infection During CPR?
CPR can involve contact with saliva, blood, vomit, and other body fluids. Following standard precautions and using appropriate protective equipment can help reduce the risk of infection for both the rescuer and the patient.
1. Use a Barrier Device for Rescue Breaths
When rescue breaths are provided, use an appropriate barrier device, such as a pocket mask or bag-valve-mask (BVM), according to your training, available equipment, and current resuscitation guidance.
A barrier device helps reduce direct contact between the rescuer's mouth and the patient's mouth during rescue breathing.
2. Wear Appropriate PPE
Wear PPE based on the anticipated exposure. Gloves are appropriate when contact with blood, body fluids, mucous membranes, or non-intact skin is expected. Use eye or face protection when splashes or sprays are possible.
If blood or body fluids are present, avoid unnecessary direct contact and use appropriate protective measures.
3. Practice Hand Hygiene
Clean your hands before and after patient care and after removing gloves. If your hands are visibly soiled, use soap and water. When appropriate, use an alcohol-based hand sanitizer and rub your hands until they are completely dry.
4. Handle Contaminated Materials Safely
Treat blood and certain body fluids as potentially infectious. Use appropriate PPE when cleaning contaminated surfaces or handling contaminated materials. Dispose of waste and contaminated supplies according to your workplace or local procedures.
5. Clean and Disinfect Reusable Equipment
Reusable CPR equipment should be cleaned, disinfected, or reprocessed according to the manufacturer's instructions and applicable infection-control procedures. Pay particular attention to equipment that comes into contact with the patient's mouth, secretions, blood, or body fluids.
Do Not Delay Life-Saving CPR
In an emergency, infection-control measures should be balanced with the need to provide timely life-saving care. Use available PPE and barrier devices when practical, but do not create unnecessary delays in starting CPR.
