Body substance isolation: Difference between revisions

'''Body substance isolation (BSI)''' 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 illnesses such as [[HIV]] or [[hepatitis]] so as to reduce as much as possible the chances of transmitting these illnesses.<ref name=autogenerated1987>{{cite journal|last1=LYNCH|first1=PATRICIA|last2=Jackson|first2=M. M.|last3=Cummings|first3=M. J.|last4=Stamm|first4=W. E.|title=Rethinking the Role of Isolation Practices in the Prevention of Nosocomial Infections|journal=Annals of Internal Medicine|date=1 August 1987|volume=107|issue=2|pages=243–6|doi=10.7326/0003-4819-107-2-243|pmid=3605901}}</ref>  This technique was first implemented at Harborview Medical Center in Seattle, Washington.<ref>{{Cite journal |last=Lynch |first=P. |last2=Cummings |first2=M. J. |last3=Roberts |first3=P. L. |last4=Herriott |first4=M. J. |last5=Yates |first5=B. |last6=Stamm |first6=W. E. |date=February 1990 |title=Implementing and evaluating a system of generic infection precautions: body substance isolation |url=https://pubmed.ncbi.nlm.nih.gov/2156467 |journal=American Journal of Infection Control |volume=18 |issue=1 |pages=1–12 |doi=10.1016/0196-6553(90)90204-6 |issn=0196-6553 |pmid=2156467}}</ref> BSI is similar in nature to [[universal precautions]], but goes further in isolating workers from [[pathogen]]s, including substances now known to carry HIV.<ref>{{Citation |last=Kopitnik |first=Nancy L. |title=Universal Precautions |date=2025 |work=StatPearls |url=http://www.ncbi.nlm.nih.gov/books/NBK470223/ |access-date=2025-12-23 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29262198 |last2=Kahwaji |first2=Chadi I.}}</ref>

[[Universal precautions]] were introduced by the [[Centers for Disease Control and Prevention|Center for Disease Control and Prevention]] in 1985 in response to the HIV epidemic.<ref>{{cite journal|title=Leads from the MMWR. Update: universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other bloodborne pathogens in health-care settings|journal=JAMA: The Journal of the American Medical Association|volume=260|issue=4|pages=462–465|doi=10.1001/jama.260.4.462|year=1988}}</ref><ref>{{Citation |last=Kopitnik |first=Nancy L. |title=Universal Precautions |date=2025 |work=StatPearls |url=http://www.ncbi.nlm.nih.gov/books/NBK470223/ |access-date=2025-12-23 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29262198 |last2=Kahwaji |first2=Chadi I.}}</ref> In 1987, these guidelines were adjusted by a set of rules known as body substance isolation. In 1996, core elements of both universal precautions and BSI were integrated into a practice known as standard precautions.<ref>{{Citation |last=Kopitnik |first=Nancy L. |title=Universal Precautions |date=2025 |work=StatPearls |url=http://www.ncbi.nlm.nih.gov/books/NBK470223/ |access-date=2025-12-23 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29262198 |last2=Kahwaji |first2=Chadi I.}}</ref>

BSI went further than [[universal precautions]] in isolating workers from [[pathogen]]s, including substances now currently known to carry [[HIV]]. These pathogens fall into two broad categories, blood-borne (carried in the body fluids) and airborne. The practice of BSI was common in pre-hospital care and [[emergency medical services]] due to the often unknown nature of the patient and their disease or medical conditions. It was a part of the National Standards Curriculum for Prehospital Providers and Firefighters. Types of body substance isolation included:{{cn|date=August 2022}}

It was postulated that BSI precautions should be practiced in an environment where treaters were exposed to bodily fluids, such as:

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

* [[Prion]] diseases (e.g., [[Creutzfeldt-Jakob disease]])