Blood Play Safety
Diana Savage © 2003
Rough Draft
Introduction
The general wisdom of people is that blood handling, blood play and blood
exchange should not be engaged in. Yet there are individuals who for various
reason desire to engage in this behavior. This includes "vampires" and "blood
fetishes." What ever the motivations of these individuals are there is an
attended risk. These risks can however be greatly reduced by following
appropriate precautions. Since any activity that exposes one person to another
person's blood is inherently dangerous, involvement in such activities should
always be consensual and the individuals competent to make an informed risk
assessment. To make this assessment the individuals need to be aware both of the
risks and precautions which can reduce these risks.
What are Your Aims?
The first step if you are going to be handling blood is to determine what your
aims or goals are. This will help determine what level of precautions you should
be taking. I have divided the general goals into four levels of contact. These
are clinical, aesthetic, contact and ingestion.
Clinical: In this category your interest is
purely utilitarian. You are obtaining blood form someone else for a specific
task. For example this could be obtaining blood for a ritual. The hallmark of
the clinical category is you do not need to have any contact with the blood. For
people in this category the primary method of safety is to avoid any actual
contact with the blood.
Aesthetic: In this category your interest
is to do something with the blood which involves handling but direct contact can
be avoided. Latex or other barrier gloves can be used at all times. Most
applications in this category are of an esthetic nature, painting, or creating a
scene. Like in the clinical category the primary safeguard is to avoiding
contact with the blood, but unlike clinical category the risk of exposure is
markedly increased by your continued exposure to blood, thus greater care must
be taken since the chances of accidents are increased.
Contact: As indicated this category
includes bodily contact with blood. Contact is assumed not to include contact
with mucus tissue, open wounds, or ingestion. When the activity falls within
this category using blood avoidance obviously can not be used as a safeguard and
other precautions become paramount. If reasonable precautions are taken there is
still little risk, but if they are not followed the risk serious. A combination
of donor screening and personal integrity of the skin is the main safeguards for
this category.
Ingestion: This is the highest risk
category. Blood is ingested, makes contact with mucus membranes or enters an
open wounds. This includes drinking, bloody sex, and exchanging blood. Contact
is made and most contact safeguards are bypassed. The only protection in this
category is proper screening.
General Information
To understand what kind of precautions there are and why they are taken it is
necessary to understand some basic information. There are several dangers from
exposure to blood, they are wound infection; infection from blood borne, decay
or contaminate pathogens; and poisoning. I will not be dealing with the first
category as this has to do with maintaining proper sanitation for the blood
donor and proper wound protection. The second category, blood borne pathogens is
the most serious. Decay and contaminate pathogens are a special cases and will
be only dealt with briefly. The last category is only significant for those in
the fourth category, ingestions and has to be dealt with in the screening
process.
Diseases:
As mentioned before there are three general types of disease pathogens which
need to be avoided: blood borne, decay and contaminate. The later can be avoided
by sterilizing site blood will be obtained from thoroughly and by only using
sterile equipment. The second occurs primarily when dead blood is used and will
be discussed later. Blood borne pathogens are diseases which the donor has
either actively or inactively. The most serious of these are HIV and hepatitis.
There are also a wide range of less common pathogens. One exception to this rule
results if the blood donor has recently been abroad, especially in the third
world. Provided there are no open wounds, including bleeding gums or ulcers HIV
is less of a problem than with unprotected sex. This does not mean there is not
danger, just less. Hepatitis A on the other hand is highly infectious if
ingested.
Blood Types
For the purposes of this paper there are two types of blood, living blood and
dead blood. Living blood comes from a living creature and is fresh. There is no
danger of exposure from decay pathogens if exposure is to live blood unless the
blood is obtained through an infected region. To avoid this never obtain blood
from site near an existing wound or in an area where the flesh is reddened.
Exposure to dead blood generally occurs when the blood used has been stored too
long, has not been stored without the proper preservatives, or is menstrual. It
is unwise to utilize blood form any of these sources, but if ingestion of any of
these takes place the consumer should recognize they are risking contracting
various diseases which come from decaying tissue. The risk low and seldom life
threatening if obviously decaying blood is avoided. Poorly stored dead blood is
also a potential source of contaminate pathogens such as salmonella and ecoli.
Precautions
Preliminary Precautions
Anyone handling blood should get a hepatitis series vaccine. This will provide
protection against hepatitis A, B and D. It offers no protection from hepatitis
C or HIV. No mater what level of blood handling you will be engaged in this
precaution is recommended.
Screening
Medical screening is highly recommended for all categories of blood handling.
For clinical and aesthetic category users screening is less important but they
should do at least a preliminary screening for the protection of the donor. If
the screening is not done, then if an accident happens such as needle stick or
blood contamination takes place medical attention is highly recommended.
The first step in screening is to protect
the donor. This primary consists of checking for medical conditions and
medications which might affect the donor. This information is also required for
individuals in the ingestion category. Obviously one should not engage in blood
activity with someone who suffers from hemophilia or other blood clotting
problems. The same is true if the individual suffers immune deficiency problems
since the chance of infection are increased. Medications should also be checked
for. It should be noted if the donor is taking any blood thinners since these
will cause them to bleed more. Blood thinners include all anti-coagulants,
aspirin, alcohol, garlic and ginger. Other medications are important if the
blood will be ingested. Many medications are carried in the blood and ingesting
the blood will result in medications entering the consumer's blood system. For
this reason never ingest a person's blood who is on chemotherapy, it will make
you sick. If you take a MEOI medication or a SSRI , be careful not to ingest
blood of a person who is taking the other type of medication. There are serious
interactions between these medications. You should also be aware of any other
medical counter indicated by a medication you taking.
Another class of medications to be aware of are sleeping medication such as
trazadone or and anti-anxiety drugs such as benzodiazepines including klonopin
and clonazepam. These drugs can cause the person who has consumed them to become
dozy or disoriented.
The second step in screening is to check
the donor's history. A person who has been out of the country, especially in the
third world may have blood borne pathogens which are not normally tested for and
additional caution should be taken with them. Intravenous drug users; those who
ingest blood, especially who do not practice careful screening; individuals who
engage in unprotected sex; bi-sexual and homosexual man, individuals on dialysis
and other individuals who engage in other high risk behaviors should be screened
more carefully. Individuals with a history of Hepatitis A, B, C, HIV or other
blood borne pathogens should never be considered as donors for ingestion and are
of greatly increased risk for contact.
The third step is to screen a person's
current medical history. If the donor's blood is going to be ingested, they
should have been recently tested for Hepatitis and HIV. The person who is going
to ingest the blood show see the test results not just accept the donors word
and may want to physically company the person when the get tested.
During the Blood Scene
These precautions are the primary line of defense for people in the clinical and
aesthetic categories. Individuals in the contact or ingestion categories should
follow as many of these precautions as possible.
Whenever possible, blood contact should be
avoided. Latex or other gloves should be used to avoid blood contact. The site
from where the blood is to obtained should be healthy and sterilized. The hands
of the person obtaining the blood should also be washed and sterilized. Sterile
equipment should be used. The equipment can be autoclaved, dry heated or boiled.
After blood handling equipment should be promptly sterilized or discarded in a
manor that no one else will be exposed to the blood. Needles should be placed in
a sharps container and never put directly into the garbage. Check with your
city, county and state on how to dispose of what qualifies as a sharps container
and how to dispose of it. The laws vary depending on locality. Blood should
never make contact with any surface where there is a healing or open wound.
Direct contact of the mouth with the donor's wound should be avoided since the
mouth often carries infectious agents. If blood is ingested straight from the
donor additional care must be made to avoid wound infection. Blood should never
touch mucus membranes such as the mouth, genitals, nose or eyes. If blood is
going to be ingested there should be no sores in the mouth, the gums should not
be bleeding and the person should not have ulcers. If bloody sex is to be
engaged in, the same basic rules apply. The risks become much higher if both
blood and rough sex are mixed.
Consent and Informed Risk
When ever there is a blood exchange of any kind all individuals should consent
to it. Consent can only be given by those who are legally qualified to give
consent. This precludes blood scenes with children, the severely mentally or
developmentally challenged, and mentally ill who are in custodial care. All
individuals should be fully informed of the risks involved so they can make an
informed risk assessment. Withholding pertinent information even if not ask for
is unacceptable and may leave the person withholding information open to legal
action. Ethically permission from an intoxicated person or mentally
incapacitated person should not be considered informed.
Conclusions
If these precautions are followed between informed consenting adults the risk of
blood handling should be minimal or greatly reduced. There is no such thing as
safe blood handling but the risk can be reduced. When risky blood handling is
engaged in the individuals should be knowledgeable of the risks and rigorously
screen participants to reduce the risk.
Sources: National Center for
Disease Control. (2003). "Viral Hepatitis".
Online at
http://www.cdc.gov/ncidod/diseases/hepatitis
RxList.com. (2002). Internet drug index. Online at
http://www.rxlist.com
Diana Savage © 2003
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