Massage & Bodywork

May/June 2012

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She adjusted one fitted sheet, then realized that with six clients on the books for her seven-hour shift, her time to dress her table between appointments would be extremely limited. So she used an old trick: she layered the rest of the fitted sheets on top of the first, so she could simply peel them off one by one. She quickly folded the extra, slightly damp flat sheets and stacked them on her open shelves where she kept towels, bolsters, books, and other equipment. As Myrtle fitted her face cradle into the top of the table, she realized it was a little sticky. From the top drawer of her desk, she grabbed an alcohol-soaked towelette: a leftover from her last trip to the barbecue restaurant. She quickly wiped down the face cradle before stacking six covers on it. Then she used the moist towelette to wipe her doorknob, the light switch plate, her bottle of lubricant (which was getting a little grimy), and lastly, her own hands. Surveying the room, Myrtle nervously bit the loose skin off her hangnails, and decided she was ready to greet her first client. How many mistakes did Myrtle make? (Answer: plenty.) Let's take a look. PRINCIPLES OF HYGIENE Universal Precautions are a set of protocols that were introduced in 1987 (after HIV/AIDS and hepatitis B had become major public health issues) to create some uniformity in how medical professionals could limit contact with body fluids in the working environment. Standard precautions were added to include guidelines on how to avoid all potentially harmful body fluids, including amniotic fluid, blood, blood- tinged saliva, breast milk, cerebrospinal fluid, pericardial fluid, pleural fluid, semen, synovial fluid, vaginal secretions, and vomit (emesis). Obviously massage therapists are unlikely to be exposed to cerebrospinal, pericardial, or pleural fluid in the course of an average day, but some of these others are not outside the range of possibilities, especially blood, blood-tinged saliva, breast milk from lactating women, and vomit. It is important to note that sweat and tears— perhaps the fluids that massage therapists are exposed to most often—are not described as infectious fluids. The methods that infectious agents use to jump the gap from one host to another have been exhaustively studied. The process essentially boils down to three issues: a reservoir or source of the infectious agent, a mode of transport, and a susceptible new host. Possible reservoirs can include other humans or animals, or inanimate habitats like contaminated computer keyboards, food that harbors potentially dangerous bacteria, or cash that may be handled by hundreds of people. The susceptibility of a new host Definition of Terms • Cleaning is the removal of soil through manual or mechanical means, often in preparation for disinfection or sterilization. • Disinfection is the destruction of pathogenic microorganisms or their toxins by direct exposure to chemical or physical agents. Disinfectants are described as low-, intermediate-, and high-level. These interventions can kill most pathogens, but bacterial spores may be spared. • Sterilization is destruction of all microorganisms in a given field. It is accomplished through baking, chemicals under pressure, or steam under pressure. • Sanitation is use of measures designed to promote health and prevent disease; it usually refers to creating a clean environment, but does not specify the level of cleanliness. • Plain soap is any detergent that contains no antimicrobial products or only small amounts of antimicrobial products that act as preservatives. • Antimicrobial soap is a detergent that contains antimicrobial substances. • Alcohol-based hand rub contains 60 percent to 95 percent alcohol (usually ethanol, isopropanol, or both). Celebrate ABMP's 25th anniversary and you may win a refund on your membership. 37

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