COVID-19 Guidelines

Role of ultrasound in the examination of COVID-19 patients

Ultrasound is a widely performed diagnostic imaging technique and can be useful in the examination of patients with COVID-19. An ultrasound exam may be performed in three different settings: in an emergency room or ICU, at the patient’s bedside, or in the radiology department. It is highly recommended that practitioners performing ultrasound exams on confirmed COVID-19 patients wear adequate protective clothing and use a dedicated ultrasound transducer for infected patients. Taking these measures will reduce the risk of contaminating the medical staff as well as other patients in the hospital or clinic. The number of ultrasound exams performed on COVID-19 patients should be based on how beneficial the clinician deems them to be. Lastly, COVID-19 patients should be isolated from the rest of the general public when being examined to reduce the risk of transmission.

Specific risks of performing ultrasound exams on COVID-19 Patients

The use of an ultrasound procedure (sonogram or Doppler) involves:

Close contact with the patient
Prolonged contact (10 minutes or more)
Physical contact with the patient and the objects and equipment in the patient’s vicinity
It signifies a high level of risk of exposure to transmission through droplets and physical contact

This requires any clinician performing an ultrasound exam on a patient with COVID-19 to apply protective measures.

The patient should wear a surgical mask, and if possible, should disinfect their hands with a hand sanitizer solution
A colleague should assist the clinician in putting on personal protective equipment (PPE) prior to conducting the procedure
The clinician should:
- Disinfect their hands with a hand sanitizer solution before and after the ultrasound exam
- Wear a surgical mask (or N95 mask)
- Wear a suitable outfit:
  - Surgical gown if the healthcare facility requires it (avoid using plain clothes with a simple gown)
  - Hygiene cap
  - Disposable gown
  - Single-use plastic apron (only if the clinician comes into contact with bodily fluids, thus this is dependent upon the condition of the patient)
  - Reusable plastic glasses (or visor mask)
  - Wearing gloves is an option but one must be cautious because these may give a false sense of security from risk of transmission. It is highly recommended that they be used when there are bodily fluids present.
- Protect the ultrasound transducer with a sterile probe cover. If there are bodily fluids present, then the ultrasound machine may also be protected with a sterile equipment drape to prevent cross-contamination.
- If possible, it is recommended that a room be isolated, and an ultrasound transducer be dedicated solely for COVID-19 patients (or those suspected to have the coronavirus). This room must be able to be ventilated for 20 minutes between each patient.
- Cleaning of the device with hospital-grade disinfectants including the probe, the cables, the keyboard, and the probe holders and disinfection of the examination table following the exam.

Key takeaways

Ultrasound in the current pandemic context is a high-risk procedure when performed on a confirmed or suspected COVID-19 patient.
It is therefore recommended that medical staff limit the activity of ultrasound for the duration of the pandemic and prioritize scanning COVID-19 patients
It should be noted that SAR-COV2 frequently causes a disturbance of the liver balance and therefore should not lead to the use of a liver ultrasound

EDM Medical Solutions provides a wide array of disinfection products that can aid in reducing the risk of COVID-19 transmission. Our products are suitable for all types of medical practices, including hospitals and clinics, and for specific settings, such as interventional radiology and the OR environment. We also offer products that have been tested and approved as effective against COVID-19, such as the Parker Protex disinfectant spray. These medical grade sprays and wipes can be used on a variety of surfaces and are suitable for the disinfection of ultrasound transducers. However, ultrasound transducers should still undergo high-level disinfection if possible to ensure the maximum level of patient safety is achieved.