Control Your Toys (it's not all in the wrist)

• Chose wisely. Toys that are hard to clean are riskier
• Chose easy-to-clean toys. 
• Non-porous materials are easier to clean than porous materials
• Some kinds of rope are easier to clean than others
• Rubber floggers are easier to clean than leather
• Protect the toy during use (eg, cover a dildo with a condom)
• Mod it to make it easier to clean (eg, polyurethane a cane)
• Make “gifts” (eg, CBT rope becomes the property of the bottom). Toys that breach the body's defenses are riskier
• It's not just needles – tight rope bondage, Wartenburg wheels, canes, floggers and more can all breach skin.
  

Control Your Environment

• No matter how large or small your environment, know its condition. Make sure it has been disinfected properly (“wiped”). For “non-critical” areas, commercial disinfectants are fine. If using a sterile setup, plan ahead about how you will keep sterile items sterile – its harder than you think
• Any play involving blood should be isolated from other play areas and well protected with absorbent towels or tarps – blood is hard to clean out of upholstery and carpets.
• Blood can be aerosolized – be aware of this when you decide to get close to blood play, or put others close to your own blood play. 

Control the Participants

Control Yourself. Know what needs to be done.  Do it.  Even if its inconvenient.  Even if you're horny.

• Be Advised. This may not always be possible, but discussing your type of play with your physician may result in helpful advice or preventive measures.  This is especially true if the bottom has ever been told they need to take antibiotics before having dental work done.
• Be immunized. The most problematic blood borne pathogen these days is not HIV, but members of the Hepatitis family.
• Be well. Odds are that if you're sick you won't want to play, but if you do, don't.
• Be clean. Soap and water is a good start, but following up with a hand disinfectant like Purell, Technicare or Vionexx is better.
• Be aware. Toys can get contaminated in an instant 

Control Your Bottom

• Take a medical history, including the Top's – pathogens can go both ways (especially with sharps).  Be on the look out for: immunosuppression, whether directly from illness or from the side effects of medications, diabetes. circulatory problems, certain heart Issues
• Be clean.  Have your bottom bathe, use Betadine, Hibiclens or the like if there will be “critical” contact (eg, needles)

Control Your Audience

• Don't let non-participants participate.  Actual incident – non-player picks up a sharp, tests the tip with his finger, puts it back on the tray.
• If there will be blood, be sure the audience (and the DM) knows  in advance

• Protect Your "Field".  Prepare your work area to avoid contamination of instruments, skin or gloves
• You may need to have someone handle "crowd control" for you.  Nothing attracts dirty hands like sterile instruments.
• Protect Yourself.  Wear protective attire (eg, gloves, masks, eye shields)
• Protect Your Bottom. 
• Protect the  skin (depending on the procedure: clean or prep with an antiseptic)
• Protect the instruments: Use aseptic technique in handling instruments

Clean Up

• Disposable Sharps should be in a sharps box
• Reusable sharps or other nonporous toys should be wrapped to prevent inadvertant pricks, and kept in a container marked “Dirty”
  
• Dispose of any waste (used disposables) in an appropriate manner to protect kids, garbagemen, etc
  
• Disinfect the play area
  

There are a number of ways people use to get instruments and body parts to, and maintain them at, the desired level of disinfection. The following is what the presenter does, and is neither endorsement nor condemnation of any particular protocols

Instruments

• Clean: For new instruments, be sure they have been degreased. With instruments that have been used, rinse off any gross debris.  With new and used instruments, thoroughly scrub off any remaining contaminants (mostly blood and dirt) with soap and water.   Brownie points for using an enzymatic cleaner, such as All-in-One (enzymatic cleaners remove the "bio-film" that forms on instruments, making disinfection or sterilization markedly less effective). Rinse thoroughly with clean water. Air dry if still wet. Do not handle by “the business end”. Store in a clean, closed container. Clean your instruments as soon as possible after using them -- it helps avoid formation of a "bio-film" that makes cleaning, disinfecting and sterilizing more difficult.
• Disinfection: As above, but in addition, place instruments in a 10% Chlorox / water solution for ten minutes, or use another disinfectant per the manufacturer's recommendations. Rinse THOROUGHLY with sterile water.  Store in a disinfected, closed container. Do not use flammable disinfectants near open flames.
• High Level Disinfection (HLD): High Level Disinfection (HLD) kills virtually all microbes, but may not kill "spores", which are the "dormant" phase of bacteria. The process is similar to "regular" disinfection, but a high level disinfectant  is used instead of the bleach solution.  An HLD is often a chemical sterilant that is used in lower concentrations or for shorter periods than needed for sterilization.  Once an instrument has soaked per the manufacturer's recommendation, remove the instrument from the disinfectant, rinse THOROUGHLY with sterile water, use immediately or air dry, and store the instrument in a container that has been High Level Disinfected. Do not use flammable disinfectants near open flames.
• Sterile: Sterile means all germs, even spores, are killed.  Most sterile items are disposable and come in sterile packages. Reusable instruments should, ideally, be autoclaved, a process your neighborhood piercer may be willing to help you with (especially if you buy something). Sterile processing has a number of advantages: there are indicators that can be used to show an instrument has been sterilized; the instrument can be sterilized in a package, which keeps the instrument sterile until it is used; there are no toxic chemicals involved. When it comes time to play, open sterile packages carefully to avoid touching the interior of the package – this allows you to use the package as a sterile surface should you need it. Once everything is laid out, put on a new pair of sterile gloves to use the instruments. If the sterile instrument touches anything that is not sterile, do not use it. There is no “5 second rule” here. Try to avoid touching the “business end” to anything.

• Clean: Soap and water clean. Dried with paper towels or freshly cleaned towel.
• Prepped:  The best prep on the market currently is Hibiclens (chlorhexadine2%) or ChloraPrep, whch is chlorhexadine and 70% alcohol.  It can either be used in sterile gauze or in a prepackaged applicator(ChloraPrep).  If using Hibiclens, start with a sterile gauze wet with 2% Hibiclens or chlorhexadine, wiping first up and down  Next wipe side to side. Then wipe up and down again with the last wipe. This gives dual action cleaning – kills germs and moves dirt and germs away from the site.  Different sizes of Chloraprep tell you how large an area each applicator will cover, either wet or dry.
  
  

Alternative skin disinfectants:

• Technicare – good for dry or sensitive skin, can be used on mucosa (but not too frequently)

• Povidone iodine (Betadine) – effective, but beware of iodine allergies
  

Urethra: Do not prep inside the urethra. For men, wipe the head of penis (including the easily accessed bit of the urethra) with chlorhexadine 2%, povidone iodine (Betadine) or, as a last resort, 70% isopropyl alcohol. For women, wipe the urethral area with chlorhexadine 2% or povidone iodine (aka Betadine).

Anus: Soap and water clean outside, and, depending on taste (poor choice of words – sorry) you may also wish to do a Fleet enema.

Aftercare

Needles, Scratches, Minor Cuts: 

• Alcohol may be used, but it hurts. Ooooh …..
• Wounds may be cleaned out with sterile saline (Wound Wash), but should otherwise be left alone.
• If large enough to require a bandage, use a sterile non-stick dressing.

Catheterization, Sounding: You're watching for a UTI here. Its symptoms include frequent need to pee, urgency to pee, painful pee, lower abdominal pain, cloudy or foul smelling pee, any fever. If you get any of these, go to the doctor.

Scrotal Infusion: Scrotal pain, unusual sensitivity to pressure, any fever, or any other of the signs of infection. If you get any of these, go to the doctor.

Pain, sensitivity to pressure, redness around the site, pus, any fever, drainage that is red or red and pus, or an enlarging, not draining area.

Sharps:  Pain, sensitivity to pressure, any fever, or any other of the signs of infection. If you get any of these, go to the doctor.