Ultrasound Infection Control in Management of COVID-19


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Lung ultrasonography has shown major utility for management of COVID-19, or the Coronavirus, with respiratory involvement due to its safety, repeatability, absence of radiation, low cost and point of care use.1 Echocardiology will also be imperative in the care of patients suspected of or testing positive for COVID-19 due to the increased risk of cardiovascular complications.8

During these critical times, CIVCO is here to serve you. CIVCO is a trusted partner to clinicians and ultrasound manufacturers around the world in the efforts to control the spread of infection.

The safety of patients, front-line healthcare professionals, and our employees is our first and utmost priority in this united fight against COVID-19.

Standard Precautions


The implementation of standard precautions are the minimum steps to prevent the spread of infection and protect healthcare professionals. According to the American Professionals in Infection Control (APIC), standard precautions include:7

  • Hand hygiene
  • Use of personal protective equipment (PPE)2
    • Either an N95 mask, for which one has been fit-tested, or a powered air-purifying respirator (PAPR)
    • A face shield or goggles
    • A gown
    • Gloves
  • Safe injection practices
  • Safe handling of potentially contaminated equipment or surfaces in the patient environment
  • Respiratory hygiene/cough etiquette.

Per World Health Organization guidance, the correct and consistent use of PPE also helps reduce the spread of pathogens. PPE effectiveness depends strongly on adequate and regular supplies, adequate staff training, appropriate hand hygiene, and appropriate human behavior.5

Envision

The safe handling of potentially contaminated equipment includes preventing the spread of infection when using ultrasound. Disposable covers, such as long ultrasound probe sheath covers, should be considered to reduce droplet and contact contamination of equipment and other environmental surfaces.2

  • A long sheath cover of the ultrasound unit and cable should be used to minimize contamination of the equipment.
    • Per the International Society of Ultrasound in Obstetrics & Gynecology (ISUOG), commercial transducer covers or condoms should be considered for transvaginal examinations or invasive procedures, and a cover for the ultrasound cable is recommended.10
  • Non-essential parts of the ultrasound cart may best be covered with drapes to minimize droplet exposure.
  • Use only covers designed to serve as a viral barrier for ultrasound. Australasian Society of Ultrasound Medicine (ASUM) and Australasian College for Infection Prevention & Control (ACIPC) warn against the use of “Home-made solutions such as plastic bags, cling film, surgical gloves or transparent film dressing,” as they are not substitutes for ultrasound covers.11

CIVCO ultrasound probe covers serve as effective viral barriers to protect against microbial migration of viruses such as SARS-CoV-24. Our covers have been tested by an independent laboratory to evaluate the barrier properties to penetration by bloodborne pathogens and are effective against human viruses 27 nanometers (nm) and larger. The SARS-CoV virus is estimated to be 60-140 nm in diameter.6

Ultrasound Probe Cover & System Drape Product Options


Note: Not all products available in all countries.

Infection Control for the At Risk COVID 19 Population

During these critical times, CIVCO is here to serve you. CIVCO is a trusted partner to clinicians and ultrasound manufacturers around the world in the efforts to control the spread of infection.

Cardiology Infection Prevention

Infection control and prevention is a primary focus of cardiology departments, especially when dealing with SARS-CoV-2, which is highly contagious. Recent data suggests SARS-CoV-2 can infect the heart muscle, which may require the use of transesophageal (TEE) procedures to detect potential heart failure.9

According to the American Society of Echocardiography (ASE), “patients under investigation or confirmed with COVID-19 may still require TEEs in several clinical situations…TEE probes should undergo cleaning in the room (including the handle and chord), then be transferred in a closed container to be immediately disinfected according to the manufacturer’s recommendations.”8

Transport Tray CIVCO’s TEE Probe Transport and Enzymatic Sponge Bundle is designed to properly pre-clean and transport your ultrasound probe in a closed container promptly after the procedure. The tray is single-use to prevent the spread of infections.

ASTRA

CIVCO's ASTRA® automated reprocessor and GUS Disinfection Soak Stations™ provide a safe way to reprocess transesophageal (TEE) probes.

GUS

Transesophageal (TEE) Infection Control Product Options


Implement Environmental Infection Control3

  • Dedicated medical equipment should be used when caring for patients with known or suspected COVID-19.
    • All non-dedicated, non-disposable medical equipment used for patient care should be cleaned and disinfected according to manufacturer’s instructions and facility policies.
  • Ensure that environmental cleaning and disinfection procedures are followed consistently and correctly.
  • Routine cleaning and disinfection procedures are appropriate for SARS-CoV-2 in healthcare settings, including those patient-care areas in which aerosol-generating procedures are performed. For example, using cleaners and water to pre-clean surfaces prior to applying an EPA-registered, hospital-grade disinfectant to frequently touched surfaces or objects for appropriate contact times as indicated on the product’s label.

Disinfecting Sprays


NOTE: Due to shortages in disinfecting wipes, CIVCO Medical Solutions suggests customers purchase disinfectant sprays and refill the spray bottles with disinfectant solution. Lint-Free Wipes are available for purchase to use with disinfectant spray.

Product Description Part # Active Ingredient EPA Registration Number Contact Time
Protex disinfectant spray, 12oz 610-1079 Quaternary ammonium 6836-152-82613 10 min
Protex disinfectant solution, gallon 610-2379 Quaternary ammonium 6836-152-82613 10 min
TrueCare Sterile Lint-Free Wipes, 300 per case 610-1354 N/A N/A N/A
Spray

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REFERENCES

  1. Peng, Q., Wang, X. & Zhang, L. Findings of lung ultrasonography of novel corona virus pneumonia during the 2019–2020 epidemic. Intensive Care Med (2020). https://doi.org/10.1007/s00134-020-05996-6
    From https://link.springer.com/article/10.1007%2Fs00134-020-05996-6#citeas
  2. Information for Health Care Professionals when caring for a patient with known or suspected COVID-19 infection. American Society of Anesthesiologists (2020)
    From https://www.asahq.org/about-asa/governance-and-committees/asa-committees/committee-on-occupational-health/coronavirus
  3. From https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Finfection-control.html#infection_control
  4. List N: Disinfectants for Use Against SARS-CoV-2. Environmental Protection Agency (2020) Accessed 3.19.2020
    From https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
  5. World Health Organization (WHO), “Infection prevention and control during healthcare when COVID-19 is suspected,” Interim guidance, 19 March 2020. WHO/2019-nCoV/IPC/2020.3. https://www.who.int/publications-detail/infection-prevention-and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-is-suspected-20200125
  6. Cascella, Marco, et al., “Features, Evaluation and Treatment Coronavirus (COVID-19),” National Institute of Health (NIH). March 20, 2020. https://www.ncbi.nlm.nih.gov/books/NBK554776/
  7. American Professionals in Infection Control (APIC), “Follow all Posted Precaution Signs,” http://professionals.site.apic.org/protect-your-patients/follow-the-rules-for-isolation-precautions/
  8. American Society of Echocardiography (ASE), https://www.asecho.org/ase-statement-covid-19/
  9. Kaiser Health News, “Mysterious Heart Damage, Not Just Lung Troubles, Befalling COVID-19 Patients.” https://khn.org/news/mysterious-heart-damage-not-just-lung-troubles-befalling-covid-19-patients/
  10. Abramowicz, J., Basseal, Jocelyne, et al (2020). ISUOG Safety Committee Position Statement on use of personal protective equipment and hazard mitigation in relation to SARS‐CoV‐2 for practitioners undertaking obstetric and gynecological ultrasound. Ultrasound in Obstetrics & Gynecology. 10.1002/uog.22035.
  11. Costello, Cartan, et al. “Prevention of Pathogen Transmission during Ultrasound Use in the Intensive Care Unit: Recommendations from the College of Intensive Care Medicine Ultrasound Special Interest Group (USIG).” Australasian Journal of Ultrasound in Medicine, 26 Mar. 2020, 10.1002/ajum.12205. Accessed 20 Apr. 2020.