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Discussion

CPR Universal Precautions

Hello, I am a new nurse concerned about universal precautions while giving CPR. I know CPR can be quite bloody depending on the situation. I have been told to always wear gloves and to wear facemasks when necessary. But what about protecting your arms, neck, etc.? How do you protect these areas from bloodborne pathogens if you were to have a cut or an open wound?

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If you have a cut or open wound on those areas, it should probably already be covered while you're at work. Also, there are much messier things than CPR that you're likely to encounter on a day to day basis.

I have done a bunch of CPR. Rarely any blood. A set of gloves should do the job. Eye and face protection if your inserting an airway.

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I have dry skin and am an athlete so I commonly have a few cuts thorughout my arm that would be difficult to consistently cover. Any advice on how to avoid bbp.

CPR is messy on postop open heart surgery patients, or I would imagine anyone with a chest or abdominal incision that is relatively fresh. Otherwise things should be intact. You did say 'certain situations' though, so it sounds like you may already know this. I've had a few tamponades on postop open heart surgery patients where they were squirting blood with each compression. One spray definitely got the PA who was bagging the patient in the face. We do now stock face shields on the floor. Also putting down sterile towels on top of someone's incision while you compress is a good idea, otherwise your hands start slipping all over the place from all the blood. I have definitely had blood all the way up to my armpits and in my hair after a messy code. You just strip and wash it all off afterward. Non-intact skin should be covered at all times anyway, but especially when working with postop patients for just this reason. Eye protection and gloves are sufficient.

The messiest event I ever encountered was on a cancer patient who had a bunch of small internal tumors. Each time we performed compressions, some of the contents emitted from the patient's mouth, but there was no blood.

I did several CPR with the presence of blood or vomited materials. My view, comply to standar precaution seemengly enough. ;-)

I can only think of 1 instance of a really bloody CPR. This was a teenage trauma case and the patient got bilateral chest tubes during the code and he was bleeding out of the ETT. There was blood everywhere - on the walls and on the floor.

Aside from gastric secretions coming up the esophagus at times during CPR, there isn't usually that much to worry about.

I have dry skin and am an athlete so I commonly have a few cuts thorughout my arm that would be difficult to consistently cover. Any advice on how to avoid bbp.

you should be covering any open wounds, period. If you really have cuts up and down your arms, I would use bandaids to cover them and wear long sleeves.

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