5.2 Blood Spill Procedure

Blood Spill Procedure

A nick during cuticle work is not just a little blood. WAC 308-20-110(17) tells Washington licensees and students the exact order to follow if there is a blood spill or exposure to other body fluids during a service. The rule says you must stop and proceed in the following order. Sequence is the test. Skipping a letter, swapping glove-on and bandage, or finishing the acrylic bead because it will set is the wrong procedure.

NIC practical testing uses an OSHA-style blood exposure demonstration. That demonstration is for the exam room. The shop-legal order in Washington is the WAC 308-20-110(17) list. Learn both. Use WAC on the floor and on Washington law items. Use the NIC OSHA-style script when an examiner asks you to demonstrate blood exposure on the practical.

The nine-step Washington order

Memorize the letters. WAC 308-20-110(17)(a) through (i):

(a) Stop service. Put the brush down. Turn the e-file off. Do not complete just this nail.

(b) Put on gloves. Gloves go on before you touch the wound, the blood, or the contaminated wipe. Bare-handed first aid is not the Washington order.

(c) Clean the wound with an antiseptic solution. Antiseptic is named. Water alone is not the step. Implement disinfectant is not for living skin. Clean the wound.

(d) Cover the wound with a sterile bandage. Sterile bandage, not a cotton ball left sitting on the skin, not a piece of paper towel.

(e) Apply the glove rules after the bandage. If the wound is on a licensee hand in an area that can be covered by a glove or finger cover, the licensee must wear a clean, fluid-proof protective glove or finger cover. If the wound is on the client, the licensee providing service to the client must wear gloves on both hands.

(f) Discard all contaminated objects. Contaminated objects shall be placed in a sealed plastic bag and that bag must be placed inside another plastic bag and discarded. This is double-bagging with a seal, not tossing a wipe into the open trash.

(g) Clean and disinfect or discard contaminated equipment. All equipment, tools, and instruments that have come into contact with blood or other body fluids must be cleaned and disinfected or discarded. Multi-use metal that can be disinfected is cleaned then disinfected. Porous single-use items that contacted blood are discarded.

(h) Remove gloves. Gloves come off after contaminated waste is bagged and after tools are handled as contaminated.

(i) Wash hands with soap and water before returning to the service. Soap and water, not only a spritz of sanitizer as the legal last step. Then, and only then, may you return to the service.

Whose wound changes step (e)

Step (e) is the Washington detail people flatten into just glove. It has two branches.

Wound on the licensee, coverable area of the hand. After antiseptic and a sterile bandage, the licensee wears a clean, fluid-proof protective glove or finger cover over that area. Fluid-proof is the standard. A fashion glove that soaks through fails. A finger cover is allowed when the wound is on a finger that a cover can isolate. You do not continue with a dripping, uncovered cut because it is only your hand.

Wound on the client. The licensee wears gloves on both hands to continue serving that client. One gloved hand and one bare hand is not the rule. The client's wound is bandaged; your two hands are gloved.

If the wound cannot be covered and you cannot continue safely, you do not invent a workaround. Stop was already step (a). Returning to service in step (i) assumes the wound is managed under (c) through (e).

Double-bag, then tools, then gloves off, then soap

Steps (f), (g), (h), and (i) are easy to scramble.

Contaminated objects — gauze, cotton, a file that wicked blood, a wipe — go in a sealed plastic bag, then that bag goes inside another plastic bag, then discarded. Open trash, a single grocery sack left unsealed, or an I'll-throw-it-away-later pile on the station fails (f).

Then equipment. A metal cuticle nipper that contacted blood is cleaned and disinfected following the nonelectrical implement path in WAC 308-20-110(7), or it is discarded if it cannot be processed. An e-file bit that is disposable is discarded. The table surface that received a drop is cleaned and disinfected. Step (g) is not optional because the drop looked small.

Then remove gloves. Then wash hands with soap and water. Returning to the service without that wash fails (i) even if the bandage is perfect.

Sharp objects that contact blood also implicate WAC 308-20-110(5)(d) and (e): disposable sharps that contact blood or other body fluids go in a sealable rigid (puncture-proof) labeled container, and licensees must have those containers available whenever services are performed. The blood-spill double-bag handles contaminated objects; a bloody disposable blade or similar sharp still needs the rigid sharps container.

First-aid kit minimum

WAC 308-20-110(18) is a shop requirement, not a suggestion for well-prepared candidates. The establishment must have a first-aid kit that contains at a minimum:

• Small bandages
• Gauze
• Antiseptic
• A blood spill kit that contains disposable bags and gloves

That list is the floor. Small bandages match the sterile bandage in (d). Gauze supports cleaning and covering. Antiseptic is the solution in (c). Disposable bags are the two bags in (f). Gloves are steps (b) and (e). A kit that has only a faded box of adhesive strips fails. A kit locked in an owner's car in the parking lot is not the establishment having a kit. Personal services and mobile units are covered by this sanitation chapter; they carry the kit to the location of service.

NIC practical OSHA-style testing versus Washington shop law

Washington manicurist candidates take the NIC practical. Core Domain Section 7 is Blood Exposure Procedure, examined individually. NIC states it has adopted OSHA bloodborne-pathogen standards for how blood exposure is evaluated during testing.

The NIC practical evaluation order, in the current Nail Technology Candidate Information Bulletin, looks like this:

• Avoid all contact with blood or bodily fluids
• Use an appropriate antiseptic hand cleanser (for example, hand sanitizer) before working on the client
• Put on disposable gloves
• If an individual is bleeding, do not touch the blood; ask the injured individual to use a cotton ball or tissue to stop the bleeding and throw the used material directly into the trash
• Bandage open cuts or broken skin to prevent contact with blood
• Throw away disposable gloves immediately after using them
• Place contaminated supplies in appropriate receptacles
• Use an appropriate hand cleanser after working on a client (soap and water or sanitizer; hand washing may be simulated with sanitizer in the test environment)

On the practical, you will also be scored on English-labeled blood-exposure supplies, removing materials from the first-aid kit, visibly clean supplies, wearing gloves, cleaning the injured area with antiseptic, covering with an absorbent secured dressing, and disposing of contaminated supplies. The scripted scenario is a minor cut to your index finger, the injury is such that you can continue, and the work area or client has not been contaminated.

That is a testing procedure. It is OSHA-style, and it is what examiners grade in the NIC room. It is not a repeal of WAC 308-20-110(17).

Differences candidates must not blur:

• Legal shop order in Washington is WAC 308-20-110(17)(a) through (i). Stop service is letter (a). Gloves are (b) before wound care. Antiseptic on the wound is (c). Sterile bandage is (d). The client-versus-licensee glove branch is (e). Sealed bag inside another sealed bag is (f). Clean/disinfect or discard tools is (g). Gloves off is (h). Soap and water before returning is (i).
• NIC testing allows asking the injured person to hold cotton and toss it, and it allows sanitizer simulation of hand washing. WAC still names antiseptic on the wound, sterile bandage, double-bag, and a soap-and-water wash before return.
• NIC's first-aid kit is a practical supply. Washington's first-aid kit is a shop legal minimum: small bandages, gauze, antiseptic, and a blood-spill kit (bags plus gloves).

If a Washington law question asks what you do in a Seattle salon when a client is nicked, answer with the WAC letters. If a practical examiner asks you to demonstrate blood exposure on your index finger in the NIC room, perform the NIC OSHA-style demonstration you were trained to show. Do not tell an inspector that WAC no longer applies because NIC adopted OSHA language for scoring.

Floor examples

Everett cuticle nick on the client. You see blood at the lateral fold. (a) Stop. (b) Gloves. (c) Antiseptic on the wound. (d) Sterile bandage. (e) You wear gloves on both hands because the wound is on the client. (f) Double-bag the contaminated cotton and wipes in sealed bags. (g) Clean and disinfect the pusher or discard it if it cannot be processed. (h) Remove gloves. (i) Wash with soap and water, then decide whether the service can resume with both hands still protected as (e) requires.

Olympia e-file nick on your own finger. Stop. Gloves. Antiseptic. Sterile bandage. Because the wound is on your hand and can be covered, wear a clean fluid-proof glove or finger cover. Double-bag. Process or discard the bit and anything that contacted blood. Gloves off. Soap and water. Then return only if the cover is in place and the station is clean.

Yakima missing kit. The bandage box is empty and there are no bags. You cannot complete (d) or (f). The establishment already failed WAC 308-20-110(18) before the nick happened. Stock the kit before the book opens.

Blood exposure is a procedure with a statutory order. Memorize the WAC list for Washington shops. Perform the NIC OSHA-style demo for the practical. Do not substitute one for the other.