# Universal Precautions vs. BSI Question



## mcvey7218 (Apr 4, 2007)

Ok.  I started Basic yesterday and already have a dumb question.  In my previous healthcare employment, I was always taught that treating all blood and body fluids as if they are contaminated along with handwashing, etc. is Universal Precautions.  Now, I am also being introduced to Body Substance Isolation.  In my assignment, one of the questions posed is:

Precautions the EMT-B should take when dealing with all patients are known as:
A.  Universal Precautions
B.  General Isolation
C.  Body Substance Isolation
D.  Quarantine Isolation

In my way of thinking, both Universal Precautions and Body Substance Isolation are correct answers.  Would someone please explain the differences between the two?


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## Flight-LP (Apr 4, 2007)

Think of universal precautions as the "every pt. contact" precautions, i.e. gloves and goggles (Yes, you should wear goggles on all contacts). BSI is more of a pt. or contaminant specific type isolation, i.e. visible bleeding, vomit, masking for TB pts. etc...........


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## EMTBandit (Apr 5, 2007)

Just think of it this way the next time you think you have a "dumb question". The only dumb question is the one not asked. No shame in getting help, especially if your learning something for the first time.  When I was going through EMT school I got a lot of questions that are confusing like that one. So be prepared for more of these.


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## firecoins (Apr 5, 2007)

Unfortunately in this business, the testing wiull give you multiple correct answers or at least 2 reasonable answers.


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## BossyCow (Apr 5, 2007)

Body Substance Isolation and Universal Precautions (or Standard Precautions) are part of the whole infection control process.  BSI is a lovely acronym and you know how EMS loves those!  

Universal or Standard Precautions is the assumption that all bodily substances are assumed to be infected with everything bad, nasty and horribly contagious.  It takes away the decision of whether or not to glove up or whether or not to use a mask.  We do this universally or as a standard.  

Body Substance Isolation is keeping the icky stickies away from us.  Generally rule of thumb.. if it belongs inside a body, and its out.. don't touch it.  BSI, I also believe, includes procedures for cleaning up a spill of something nasty.  So, part of BSI is the implemenation of Standard of Universal Precautions. Clear as mud?


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## JonathanGennick (Apr 5, 2007)

*Fascinating question, actually*



mcvey7218 said:


> In my way of thinking, both Universal Precautions and Body Substance Isolation are correct answers.  Would someone please explain the differences between the two?



Interesting question, actually. I took a quick look in my EMT-Basic textbook, the Brady book, and neither the glossary nor index list the term "universal precautions". The index _does_ list the term "body substance isolation". 

A bit of googling turns up the following Center for Disease Control link:

http://www.cdc.gov/ncidod/dhqp/bp_universal_precautions.html

The page at the above link explains the term "as defined by the CDC". Just a few paragraphs into the page, you'll find the words: "Universal precautions differ from the system of Body Substance Isolation (BSI) used in some institutions. " Those words are followed by references to some articles on BSI. 

Just from my brief look here, I'm guessing that there is some fascinating history behind the definitions of the two terms that we're talking about. I'm on call tonight, waiting for something to happen. I may go and do some reading. What does each term mean, precisely? Why does EMS emphasize BSI and not the other term? What is the history behind the two terms? Does one term imply a superset of what the other term implies? Is one term fading and other gaining ascendency? Lots of really interesting questions underneath this rock that you've turned over.


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## JonathanGennick (Apr 6, 2007)

*Another helpful-looking link*

The following link looks well worth reading:

http://www.cdc.gov/ncidod/dhqp/gl_isolation_ptI.html

It gives a bit of history behind the "universal precautions" and "body substance isolation".


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## Glorified (Apr 6, 2007)

http://www.emtb.com/9e/glossary.cfm?Chapter=2&step=4&resource=glossary

you should do both.  I believe the correct answer is Universal Preacautions


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## mcvey7218 (Apr 6, 2007)

Thank you guys for your comments and posts.  I tend to "pick things apart" too often, and I have to know "why" I am doing something in order to get a firm grasp on "how" to do it.  You can tell me all day long how to do a procedure, but if I do not understand why I am doing it, then it is a lost cause.  That is why I posed the question... I need to know why BSI differs from Universal Precautions.  This "nitpicking" personality tends to screw me up sometimes!!:unsure:  Anyway... thanks guys!


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## mcvey7218 (Apr 6, 2007)

JonathanGennick said:


> Interesting question, actually. I took a quick look in my EMT-Basic textbook, the Brady book, and neither the glossary nor index list the term "universal precautions". The index _does_ list the term "body substance isolation".
> 
> A bit of googling turns up the following Center for Disease Control link:
> 
> ...



We are using Brady 10th Edition Update.  I looked everywhere in the book and could not find any info on Universal Precautions.  I asked my instructor about the difference, and he said that it is just a difference in terminology.  Anyway, after leaving class, I still need to know "why" the difference.:unsure:


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## Glorified (Apr 7, 2007)

basically universal precautions is using PPE, and being generally cautious.  BSI is just assuming all bodily fluids are contaminated.


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