Tuesday, March 28, 2017

Ultrasound Probe Infection Risk, Call For Action

Ultrasound imaging is the most widely used & rapidly growing diagnostic modality in modern medicine. Many scientific studies have shown that there is a risk of microbial cross transmission from improperly processed probes.
Though some facilities might be using high-level disinfection, & the commonly used chemical [Cidex ortho-pthaldehyde (OPA)] used to reprocess transvaginal probes are not effective against human papillomavirus (HPV). Hence, proper cleaning & disinfection of reusable medical devices has been increasingly recognized as vital in preventing pathogen cross transmission including the multidrug resistant organisms. The medical insurance companies, centers for disease control & international & national accreditation agencies are laying great emphasis on standards of care for effective cleaning & disinfection of reusable ultrasound probes.
In addition, we should be aware that the thin layer of gel applied to the skin for effective transmission of ultrasound waves have been identified as one of the sources of cross infection. This infection risk increases when probes enter body cavities where blood & body fluids are encountered.
Hence, collaboration with the full spectrum of healthcare personnel involved in these procedures (Radiologists, Sonographers, Unit Heads, Central sterilizing staff) would contribute to the higher measure of safety during patient care. Probes coming in contact with mucous membranes or non-intact skin be classified as semi-critical device & should undergo high-level disinfection.
Note: In August 2012, BBC News Channel reported the death of the patient from hepatitis B virus infection thought to be contracted via an improperly reprocessed trans-esophageal echocardiogram (TOE) probe. The patient got readmitted with liver failure 3 months after heart valve surgery. The investigation team concluded that the TOE probe used to monitor the heart was the cause & said that the decontamination procedure at the time of the incident as deficient.
  1. Using probes without adequate & appropriate decontamination procedures is an underappreciated patient safety risk.
  2. Infection Prevention & Control measures needed:
  3. Prepare a policy & procedure for probe disinfection in collaboration with experts in sterilization & disinfection.
  4. Implement the sterilization & disinfection process effectively at all times of patient care.
  5. Try using single patient use gels for probes or adhere to the manufacturer’s guideline in preventing cross infection between patients.
  6. Perform adequate & appropriate hand hygiene before & after the intervention.

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