High risk zone and good practice
Services offered in the high risk zone
The high risk zone is defined as the area in front of the face where splashes and droplets from the nose and mouth may be present, which can pose a hazard.
This hazard is present where a service treats the high risk zone, mainly the nose and mouth, or where the practitioner is directly in front of the high risk zone when the client is seated or a treatment where the client is supine on the treatment couch and the practitioner leans into and over the high risk zone to treat the client’s face, neck, scalp and shoulders.
Treatments of the high risk zone should not be offered unless provided from the side of the face or from behind the head where the client is seated. Treatments of the high risk zone or a treatment that necessitates the practitioner leaning into the high risk zone, such as treating the face, scalp, neck and shoulders with the client in the supine position, should not be offered. Instead, clients should be positioned lying on their side or in the prone position. If treatments in the high risk zone cannot be carried out whilst wearing a face covering, they should not be offered.
There are no current time limits on treatments, though we recommend that appointments be kept as short as is practically possible to do the treatment in order to reduce the risk of transmission. Guidance regarding the recommended time spent in the high risk zone must also be adhered to.
Health Protection Scotland has produced contact tracing guidance that contains information on close contact in non-healthcare settings. This suggests that ‘prolonged periods’ could be:
- no amount of time: if face-to-face contact is at 1 metre or less; (i.e. in effect this should not be permitted)
- 1 minute: if contact is 1 metre or less, but does not involve face-to-face contact
- 15 minutes: if contact is between 1 and 2 metres, whether or not contact is face-to-face
Treatments should not be provided in the area covered by a face covering – even if the client is exempt from wearing a face covering and that area is exposed. The limitation on the provision of any treatment is the ability to provide it from the side or from behind the head with the client seated or with the client lying on their side or in the prone position. If you can provide the treatment from the side or from behind the head you should reduce the time spent in the high risk zone as much as possible.
It should be noted that if, at a later date, the client is identified as a case who was infectious at the time of treatment, the individual performing the treatment will be considered a close contact and required to self-isolate regardless of the control measures implemented.
Consideration should be given to which practice is as safe as possible. Practitioners should assess their practice for all services they deliver to ensure they only provide services in the safest possible settings. Practitioners should seek to avoid skin-to-skin contact with colleagues and clients if it is not crucial for the service such as shaving, detailing or outlining. Gloves provide a barrier where there is anticipated contact with blood or body fluids and should continue to be used for any services where this is a risk as in usual practice. However, overuse of gloves leads to contamination of both the user’s gloves and the surrounding environment. Frequent hand decontamination is very important.
Good practice involves the practitioner continually moving from side to side or from the back avoiding the high-risk zone, inactive periods, and keeping the activity time involved as short as possible.