TABLE 1

Standard Precautions

Use standard precautions, as recommended by the CDC for hospitalized patients and modified by the AAP for all children in the ambulatory setting. Major features are as follows:
Hand hygiene
 • Hands should be disinfected with an alcohol-based hand rub or washed with soap and water before and after each patient encounter or an encounter with the patient’s immediate environment.
 • Hands and other body surfaces should be washed with soap and water if visibly soiled or contaminated with blood or other body fluids or if exposure to spores (eg, C difficile) or certain viruses (eg, norovirus) is likely to have occurred.
 • Hands should be disinfected with an alcohol-based hand rub or washed with soap and water before donning and after removal of gloves.
Barrier precautions to prevent skin and mucous membrane exposure
 • Gloves should be worn for contact with blood, all body fluids, secretions and excretions, mucous membranes, nonintact skin, and items or surfaces contaminated with body fluids. Gloves need not be used for the routine care of well children, including changing diapers and wiping the nose or eyes of children, except when required as part of contact precautions.17,28
 • Gloves should be worn when performing venipuncture and other vascular access procedures.
 • Gloves are not routinely required when administering injections, including immunizations, unless the person administering the injection is likely to come into contact with body substances or has open lesions on his or her hands.
 • Appropriate masks and protective eyewear or face shields should be used during procedures that are likely to generate droplets of blood or body fluids or risk of splashes.
 • Fluid-impermeable gowns or aprons should be worn during procedures that are likely to generate splashes of blood or other body fluids.
Respiratory hygiene and cough etiquette (see Table 2 and text)29,30
Handling of sharp instruments to minimize risk of injury (see text “Prevention of Exposure to Bloodborne Pathogens, Blood, and Body Fluids and Management of Injuries by Needles and Other Sharp Instruments”)
Resuscitation equipment
 • Equipment should be available for use in areas in which the need for resuscitation is predictable.
 • Mouth-to-mouth resuscitation should be avoided.