Ultrasound probes: risk of cross infection and methods to reduce it

Transcription

1 Ultrasound probes: risk of cross infection and methods to reduce it Poster No.: C-0932 Congress: ECR 2013 Type: Authors: Keywords: DOI: Educational Exhibit N. Ramesh, N. Mukiza; Portlaoise/IE Management, Soft tissues / Skin, Ultrasound, Ultrasound-Colour Doppler, Ultrasound-Power Doppler, Audit and standards, Education, Technical aspects, Education and training, Quality assurance /ecr2013/C-0932 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 9

2 Learning objectives Hospital acquired infections are on the rise leading to patient morbidity and mortality. With increased dependence on imaging, Radiology departments can be the source of transmitting Nosocomial infections, particularly in ultrasound {including bedside portable scans} and the intervention divisions. Infections can be transmitted via the ultrasound probes, the cord and the coupling gel. The poster aims to present the common methods and tips to a clean probe and ways to reduce the potential cross infection. Background Traditionally ultrasound probes are used without any protection, except during intervention and endo-cavity scanning. The connection cord also comes in contact with the patient's skin and often, due the length it is contact with the floor. Gel left on the probe for prolonged periods can harbour bacteria. In addition congealed gel on the probe and cord can cause damaged in the long run. Though probe protective material can reduce transmission of infection, studies have shown that a simple double wipe of the probe by paper towel largely reduces the incidence of Nosocomial infections Imaging findings OR Procedure details With the increase use of ultrasound there is a potential of the transducers and gel as vectors for cross infection A busy machine maybe used to scan 50 patients a day including both patients who may act as a source of infection those who are vulnerable. The transducer could act as a vector unless it is effectively cleaned. The risk increases when with intervention procedures or scans of intimate regions {scrotal, inguinal, breast etc.}. Extra care should be taken when scanning neonates or patients in the intensive care units. The best practice has yet to be established however a lack of an effective cleaning method for the probes may place the patients at risk. More over, dried up gel reduce the effectiveness and life of the probes. TYPE OF GEL:INDICATIONS Page 2 of 9

3 Sterile- Procedure penetrating mucous membrane Babies in SCBUs Non- intact skin Sterile & Bateriostatic - Endoscopic scans Non sterile- Intact skin Sterile single use gel should be used in SCBU, intervention procedures POTENTIAL ORGANISMS MRSA Klebsiella pneumoniae Staphylococcus, pseudomonas Fungi and viruses SOUND ADVICE 1.STORAGE- Gel containers should be stored in places protected from potential sources of contamination- dust, insects, rodents. Discard if package integrity breached, rotate when restocking. 1.GENERAL - A. Sterile gel must be used when employing aseptic conditions and neonates, single use container to be used in isolation wards, ICUs B. Containers/ dispensing nozzles must not come in direct contact with patients, instrumentation Page 3 of 9

4 C. Discourage topping up of non-sterile containers D. Reusable containers - maintain aseptic technique during refilling process, outside of container should be wiped clean of any residual gel, always replace cap, discard cracked reusable bottles E. Warming of gel- warmed gel should be used only when required, gel warmers must be cleaned according to manufacturer's instructions at least weekly or when soiled F. Bulk containers, always use a clean dispensing device, use a clean dry and empty container, discourage top up. Check expiry date. 3. PROBES/ TRANSDUCERS - Wipe probes with a clean, dry, soft absorbent paper towel after each procedure until they are visible clean, use Alcowipe sterets when probe used on contaminated area and at the end of each day. Weekly cleaning of probe with manufacturer recommended disinfectant. Cables must be occasionally cleaned,as they come in contact with patients and may be covered with gel 4. POST SIGNS - Signs and posters displayed in ultrasound rooms to remind users to clean probes is recommended Images for this section: Page 4 of 9

5 Fig. 1: Variety of probes used Fig. 2: Probe with gel left over a period and a clean probe Page 5 of 9

6 Fig. 3: Different sterilization methods Page 6 of 9

7 Fig. 4: Hygiene notice placed in ultrasound rooms might be helpful in reducing infection Page 7 of 9

8 Fig. 5: Hygiene notice in ultrasound room Page 8 of 9

9 Conclusion It is the responsibility of the persons working with ultrasound equipment to ensure clean probes are maintained; clean the probe after each use; regularly clean with sterilize sprays at the end of each day and after use is special situations and certain areas. References 1. Can ultrasound probes and coupling gel be a source of nosocomial infection in patients undergoing sonography? An in vivo and in vitro study. Muradali D et al; Am J Roentgenol (1995); 164(6): Ultrasound and risk of nosocomial cross infection. B Sahu & N R Fenning; Ultrasound Obstet Gynecol {2010}; 36: DOI: /UOG Medical gels and the risk of serious infection. E Wooltorton. CMAJ (Nov 2004) Vol.171. No. 11: DOI /cmaj Personal Information Page 9 of 9