5.1 Blood Exposure & Body Fluid Procedures (K.A.R. 28-24-3)
Key Takeaways
K.A.R. 28-24-3(d) steps in order: stop service, put on protective gloves, clean the injury with antiseptic and cover it with a sterile bandage, clean and disinfect everything that touched blood, then double-bag contaminated items (gloves included) into a closed waste receptacle.
If exposure to blood or body fluids is likely, the practitioner must wear single-use protective gloves, and contaminated single-use items are double-bagged, sealed and discarded in a closed receptacle (K.A.R. 28-24-3(c)).
Implements and surfaces exposed to blood are cleaned and then disinfected with an EPA-registered disinfectant or bleach solution. Kansas does not require a special hospital-grade or tuberculocidal product.
Board tips: apply antiseptic only with an applicator, seal both bags independently, put the disinfectant wipe in the double bag, and remove gloves last.
A salon blood exposure kit holds disinfectant or bleach solution, protective gloves, antiseptic solution, sterile bandages and disposable bags (Board inspection checklist).
Quick Answer: If a blood exposure occurs, K.A.R. 28-24-3(d) requires five steps in order. (1) Stop the service immediately. (2) Put on protective gloves. (3) Clean the injured area with an antiseptic and cover it with a sterile bandage. (4) Clean and disinfect all equipment, instruments and surfaces that touched blood. (5) Double-bag all contaminated items, including gloves, and put them in a closed waste receptacle. Use an EPA-registered disinfectant or bleach solution. Apply antiseptic with an applicator, seal each bag, and take your gloves off last.
The Regulation
K.A.R. 28-24-3(c): if there is a likelihood of exposure to blood or body fluids, the practitioner shall wear single-use protective gloves. Each contaminated single-use item shall be double-bagged, sealed and disposed of in a closed waste receptacle. Protective gloves means single-use gloves made of nitrile, vinyl or latex (K.A.R. 28-24-1(o)).
K.A.R. 28-24-3(d): if a blood exposure occurs, the practitioner shall perform all of the following:
| Step | Regulation text (d) | What you actually do |
|---|---|---|
| 1 | Stop service immediately | Put implements down safely. Tell the client calmly that you are pausing to take care of the cut |
| 2 | Put on protective gloves | Single-use nitrile, vinyl or latex gloves, before touching the wound or anything with blood on it |
| 3 | Clean the injured area with an antiseptic solution and cover the wound with a sterile bandage | Apply antiseptic with an applicator, not straight from the bottle, then cover with a sterile adhesive bandage |
| 4 | Clean and disinfect all equipment, instruments and surfaces that came in contact with blood | Clean, then apply an EPA-registered disinfectant or bleach solution per the label. Contaminated nippers go through the full clean, rinse and disinfect cycle |
| 5 | Double-bag all contaminated items, including gloves, and dispose of them in a closed waste receptacle | Cotton, gauze, wipes, files and gloves go into one bag, sealed, inside a second bag, sealed |
The renewal exam tests the disinfectant choice. After a blood exposure, equipment, instruments and surfaces are disinfected with an EPA-registered disinfecting solution that is bactericidal, virucidal and fungicidal, or bleach solution. Styptic, antiseptic and hot soapy water are the wrong answers. Kansas does not require a "hospital-grade" or "tuberculocidal" product.
The Board's Written Procedures (updated June 2020)
The Board publishes step lists for each person who might be cut. They add useful detail to the regulation.
Practitioner injury:
- Stop the service and clean the injured area.
- Apply antiseptic to the injury using an applicator.
- Cover the injury with an adhesive dressing.
- If bleeding is on the hand, place a disposable glove on that hand.
- Clean and disinfect all affected surfaces.
- Place all contaminated items, including gloves, in a double bag.
- Completely seal the double bags and place them in a covered waste receptacle.
- Clean hands with antibacterial soap or an alcohol-based sanitizer.
- If the injury is on the hand, put a disposable glove on that hand before continuing.
- Proceed with the service.
Client injury:
- Stop the service, and cover the practitioner's hands with disposable gloves.
- Clean the injured area and apply antiseptic using an applicator.
- Cover the injured area with an adhesive dressing.
- Clean and disinfect all affected surfaces, instruments and equipment that touched blood.
- Place all contaminated items, including gloves, in a double bag.
- Completely seal the double bags and place them in a covered waste receptacle.
- Clean hands with antibacterial soap or an alcohol-based sanitizer.
- Proceed with the service.
Disinfecting the work surface: clean contaminated surfaces with a suitable cleaner, apply disinfectant per the manufacturer's instructions (some require 10 minutes wet contact), then wipe dry with a clean cloth or paper towel.
The Board's note on procedure: every product used on the wound must be applied with an applicator. No part of the product container may touch the skin or wound. Anything that touches the skin or wound is contaminated and goes into the double bag.
Common Errors the Board Sees
The Board's "Blood Exposure Procedure Tips" list mistakes that also make good exam distractors:
- Putting used items back in the kit.
- Not removing and replacing damaged gloves.
- Throwing items into the regular trash that belong in the double bag.
- Sealing everything in the double bag except the gloves, and putting the gloves in the regular trash.
- Bagging everything, gloves included, before cleaning the station, then throwing the bleach wipe in the regular trash.
- Applying antiseptic without an applicator, unless the antiseptic is single-use.
- Letting hair, jewelry or clothing touch the skin or wound, or sneezing or coughing on it, without disinfecting before continuing.
The Board's reminders:
- The kit stays closed except while you take something out.
- Wear gloves through the entire procedure.
- Seal both bags independently.
- Gloves are the last thing removed.
The Blood Exposure Kit
The Board's compliance checklist requires every establishment to keep a blood exposure kit containing:
- a disinfectant or bleach solution that meets the Kansas definition;
- protective gloves;
- antiseptic solution;
- sterile bandages;
- disposable bags for double-bagging.
Applicators, such as single-use cotton swabs, let you apply antiseptic the way the Board's procedure requires.
Body Fluids Other Than Blood
The rule covers "blood or body fluids." Treat fluid from a blister, weeping lesion or pustule the same way: gloves, stop, contain, clean and disinfect, double-bag. Better still, a weeping or inflamed lesion is a reason not to begin the service at all (K.A.R. 28-24-3(a); section 3.3).
Putting It in Order: A Worked Example
While nipping a dead hangnail, you nick the client's lateral nail fold and a drop of blood appears.
- Set the nippers on the towel and stop.
- Glove both hands.
- Using a swab, apply antiseptic to the nick, then apply a sterile bandage.
- Put the nippers in the used-instrument container for full reprocessing. Clean and disinfect the table and anything else that touched blood, bagging the wipes you use.
- Put the swab, cotton, towel paper and wipes in a bag, seal it, place it in a second bag, seal that, and drop it into the closed waste receptacle, with the gloves removed last and bagged.
- Clean your hands and continue with fresh implements.
A client's cuticle area starts to bleed during a manicure. After stopping the service, what is the next required step under K.A.R. 28-24-3(d)?
Apply antiseptic directly from the bottle to the cut
Put on protective gloves
Double-bag the cotton and files already on the table
Disinfect the nippers so they are not left contaminated
Which product must a Kansas practitioner use on implements and surfaces that came into contact with blood?
A styptic solution
An antiseptic spray
Hot soapy water alone
An EPA-registered disinfectant that is bactericidal, virucidal and fungicidal, or bleach solution
According to the Board's blood exposure tips, which of these is a common error?
Sealing every item in the double bag except the gloves, which are thrown in the regular trash
Keeping the kit closed except when removing an item
Wearing gloves through the entire procedure
Sealing each of the two bags independently
A technician cuts her own finger while filing. After cleaning the injury, applying antiseptic with an applicator and bandaging it, what must she do before continuing the service?
Nothing more, because the bandage is enough protection
Soak the finger in disinfectant for 10 minutes
Clean and disinfect affected surfaces, double-bag contaminated items, clean her hands, and put a disposable glove on the injured hand
End the service and send the client home, since practitioners may not work with a bandage
Sections you finish are checked off in the contents.