Ultrasound Used In Patient Care
Ultrasound has become a cornerstone in the diagnosis and management of patients in many hospital disciplines of medicine and surgery and is increasingly being used in Critical Care, Emergency Departments (A&E), Anaesthesia, and indeed Primary Care and Specialty Outpatient Clinics.
To achieve the full ultrasound benefits in patient care, medical teams need to consider the contamination risk over repeated use of probes as a vector for pathogen transmission.1
The ultrasound probe can be compromised by contamination in various ways:1,2
- Transmission from patient procedure site (probe or cable),
- Probe cover microtears or perforation
- Poor aseptic technique
- Contaminated gel.
Research studies demonstrated that contaminated gel can lead to infections, but also highlight that a probe can be a vector for pathogen transmission.
- insertion of a central venous catheter. 2-3
Research Studies show that the Handle and cable section are exposed to cross-infection risk during a clinical examination – 5 Emergency Departments and 5 Intensive Care Units. 5
- 61% of samples tested positive for blood contamination
- 48% tested positive for microbiological contamination
- 57% transducers showed blood contamination
- 88% transducer cables are in direct patient contact,
- 62% transducer leads (cables) and 46% transducers showed microbial contamination.
Healthcare facilities need to review policies to ensure handle, cable and probe are adequately disinfected?. 1-5
- Hughes et.al (2008) Preventing Health Care–Associated Infections: Advances in Patient Safety and Quality: An Evidence-Based Handbook. Rockville (MD): Agency for Healthcare Research and Quality (US); Apr. Chapter 41.
- Abdelfattah R. et al. (2018) Outbreak of Burkholderia cepacia bacteraemia in a tertiary care centre due to contaminated ultrasound probe gel. J Hosp Infect. 2018 Mar;98(3):289-294. doi: 10.1016/j.jhin.2017.09.010. Epub 2017 Sep 18.
- Shaban RZ, Maloney S, Gerrard J, Collignon P, et al. Outbreak of health care-associated Burkholderia cenocepacia bacteremia and infection attributed to contaminated sterile gel used for central line insertion under ultrasound guidance and other procedures. American Journal of Infection Control. 2017; pii: S0196-6553(17)30843-X.
- Therapeutic Goods Administration (TGA). Meditech Ultrasound Gel: safety Advisory – Risk of Bacterial Contamination. Safety Information – Alerts. 2017. Available from: https://www.tga.gov.au/alert/meditech-ultrasound-gel.
- Keys M, Sim BZ, Thom Ogilvie, et al. Efforts to Attenuate the Spread of Infection (EASI): a prospective, observational multicentre survey of ultrasound equipment in Australian emergency departments and intensive care units. Crit Care Resusc. 2015;17(1): 43-46.