Universal precautions

The best protection against occupational exposure to pathogens is the use of universal (or standard) precautions in all cases.

Important precautions in obstetrics include:

1 Reducing needlestick injuries by handling used needles as little as possible, using a needle holder during episiotomy, avoiding recapping disposable needles and taking great care in recapping blood sampling barrel system needles or non disposable syringes, placing needles and other sharps in the appropriate containers

2 Washing hands with soap and water immediately after contact with blood or body fluids

3 Wearing suitable gloves when expecting exposure to blood or body fluids

4 Covering broken skin or open wounds with watertight dressings

5 Wearing an impermeable plastic apron for delivery

6 Wearing eye shield for operating or assisting at Caesarean Section, and for suturing episiotomies

7 Wearing double gloves, if possible, for all operations, which reduce considerably the amount of blood carried through if a glove is punctured

8 Using an appropriate sized needle (21 gauge, 4 cm, curved) for the repair of episiotomy, together with a technique using a needle holder

9 Passing all sharp instruments onto a receiver, rather than hand-to-hand at
Caesarean section and modifying surgical practice to use needle holders and to avoid using fingers in needle placement

10 Using long-cuffed gloves for manual removal of a placenta

11 Wherever possible, avoiding the need for suction of newborns and using wall suction or a suction machine when suction is required. Suction pressure should be less than 140 mm Hg to avoid damage to the neonate. If no other suction is available, ensuring that the trap in the mouth operated De Lee suction apparatus is functional

12 Disposing of solid waste such as blood soaked dressings or placentas safely