Recommendations for Prevention of HIV Transmission in Health-Care Settings [MMWR Vol. 36. No. 2S]

August 21, 1987 - Supplement

1. All health-care workers should routinely use appropriate barrier precautions to
prevent skin and mucous-membrane exposure when contact with blood or
other body fluids of any patient is anticipated. Gloves should be worn for
touching blood and body fluids, mucous membranes, or non-intact skin of all
patients, for handling items or surfaces soiled with blood or body fluids, and for
performing venipuncture and other vascular access procedures. Gloves should
be changed after contact with each patient. Masks and protective eyewear or
face shields should be worn during procedures that are likely to generate
droplets of blood or other body fluids to prevent exposure of mucous membranes of the mouth, nose, and eyes. Gowns or aprons should be worn during
procedures that are likely to generate splashes of blood or other body fluids.
2. Hands and other skin surfaces should be washed immediately and thoroughly
if contaminated with blood or other body fluids. Hands should be washed
immediately after gloves are removed.
3. All health-care workers should take precautions to prevent injuries caused by
needles, scalpels, and other sharp instruments or devices during procedures;
when cleaning used instruments; during disposal of used needles; and when
handling sharp instruments after procedures. To prevent needlestick injuries,
needles should not be recapped, purposely bent or broken by hand, removed
from disposable syringes, or otherwise manipulated by hand. After they are
used, disposable syringes and needles, scalpel blades, and other sharp items
should be placed in puncture-resistant containers for disposal; the punctureresistant containers should be located as close as practical to the use area.
Large-bore reusable needles should be placed in a puncture-resistant container
for transport to the reprocessing area.
4. Although saliva has not been implicated in HIV transmission, to minimize the
need for emergency mouth-to-mouth resuscitation, mouthpieces, resuscitation
bags, or other ventilation devices should be available for use in areas in which
the need for resuscitation is predictable.
5. Health-care workers who have exudative lesions or weeping dermatitis should
refrain from all direct patient care and from handling patient-care equipment
until the condition resolves.
6. Pregnant health-care workers are not known to be at greater risk of contracting
HIV infection than health-care workers who are not pregnant; however, if a
health-care worker develops HIV infection during pregnancy, the infant is at risk
of infection resulting from perinatal transmission. Because of this risk, pregnant
health-care workers should be especially familiar with and strictly adhere to
precautions to minimize the risk of HIV transmission.
Implementation of universal blood and body-fluid precautions for all patients
eliminates the need for use of the isolation category of "Blood and Body Fluid
Precautions" previously recommended by CDC (7) for patients known or suspected to
be infected with blood-borne pathogens. Isolation precautions (e.g., enteric,
"AFB" [7]) should be used as necessary if associated conditions, such as infectious
diarrhea or tuberculosis, are diagnosed or suspected.
Precautions for invasive Procedures
In this document, an invasive procedure is defined as surgical entry into tissues,
cavities, or organs or repair of major traumatic injuries 1) in an operating or delivery

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