When taking blood samples from an AIDS patient. Which precaution should be taken to collect blood sample according to guidelines?

Appeared in: PGIMER NO - 2020

Explanation

This option includes all the necessary components for full barrier protection under Standard Precautions.
Hand washing is the most fundamental step in infection control, which is included in this option.
A gown and mask provide additional layers of protection against potential splashes or sprays of blood, which is a prudent measure when dealing with a known bloodborne pathogen like HIV.
The combination of hand washing, gown, mask, and gloves ensures the highest level of safety for the healthcare provider during a procedure with risk of blood exposure.

Option A: This option is incomplete as it omits hand washing, which is the most crucial first step in any infection control procedure.
Option B: Sterile gloves are not required for a routine blood draw (phlebotomy). Clean, non-sterile gloves are the standard. Sterile gloves are reserved for invasive procedures that breach sterile body cavities.
Option D: This option is incomplete. While gloves are essential, it omits hand washing, which must be performed before applying and after removing gloves.

Clinical Relevance

Nursing practice connection: Use the key finding related to Standard Precautions and Personal Protective Equipment (PPE) to guide bedside assessment, documentation, and the next nursing action.
The core principle of Standard Precautions is to treat all blood, body fluids, non-intact skin, and mucous membranes as if they are infectious, regardless of the patient's known diagnosis. This protects both the healthcare worker and other patients.
In India, the National AIDS Control Organisation (NACO) guidelines emphasize strict adherence to Universal Precautions (an older term for Standard Precautions) in all healthcare settings to prevent occupational exposure to HIV.
What if? If the procedure involved a high likelihood of aerosol generation (e.g., bronchoscopy on a patient with respiratory symptoms), the PPE requirement would escalate to include an N95 respirator in addition to other precautions.

How to Approach the Question

First, identify the core procedure: collecting a blood sample.
Next, note the specific patient context: a patient with AIDS, which confirms the presence of a bloodborne pathogen.
Recall the principles of Standard Precautions, which are designed for handling blood and body fluids.
Evaluate each option based on the essential components of infection control. Immediately eliminate any option that omits hand washing.
Compare the remaining options. Recognize that while minimum PPE for routine phlebotomy is gloves, the question asks for precautions according to guidelines for a high-risk pathogen. The most comprehensive option that ensures maximum safety is often the intended correct answer in such scenarios.
Select the option that provides the most complete barrier protection, including hand hygiene.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 2 pp. 237-239, 238-240

E6 Nursing Fundamentals Taylor p. 199-201

Practise the full PGIMER NO - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.