Pre-Cleaning Ultrasound Probes is a Mandatory Step!
As new technologies emerge for disinfection of ultrasound probes, it's timely to restate the critical importance of pre-cleaning before you disinfect. In short, pre-cleaning is essential, whether you high-level disinfect manually or with an automated system.
The use of automated disinfection devices does not eliminate this crucial step. If pre-cleaning is skipped or performed improperly, the disinfection procedure is compromised.
Cleaning is defined as "removal of visible soil (e.g. organic and inorganic material) from objects and surfaces and normally is accomplished manually or mechanically using water with detergents or enzymatic products." 1
(Photo above illustrates the pre-cleaning of a TEE ultrasound probe)
Why do you need to clean if you have an automated disinfection system?
Cleaning removes inorganic and organic debris that can otherwise remain on the probe's surface and defeat the efficacy of the disinfection. In addition, surveyors look to see if you perform this step.
These sample questions from a Center for Medicare & Medicaid Services (CMS) survey confirm that your cleaning protocol will come under scrutiny:
- Are you following manufacturer's instructions for cleaning or evidence-based guidelines?
- Are you visually inspecting the probe prior to high-level disinfection for residual soil and re-cleaning as needed before high-level disinfection? 2
The American Institute for Ultrasound in Medicine (AIUM) recommendation for cleaning endocavity transducers emphasizes the importance: It requires cleaning and disinfection even if a probe cover or sheath is used:
"Meticulous cleaning of the instrument is the key to an initial reduction of the microbial/organic load by at least 99%. This cleaning is followed by a disinfecting procedure to ensure a high degree of protection from infectious disease transmission, even if a disposable barrier covers the instrument during use."
Drying is equally important when it comes to automated reprocessors. As with debris and gel, residual water can mitigate the disinfection process. Drying after cleaning is as important with automated reprocessors as it is with manual reprocessing. Be sure to review the automated reprocessor's instructions.
Learn the pre-cleaning steps in our blog, "How to Clean an Ultrasound Probe." Once you've completed the cleaning cycle, your ultrasound probe is ready for high-level disinfection, reviewed in "How to High-Level Disinfect Ultrasound Transducers."
- CDC Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008.
- http://www.cms.gov. Sample CMS Survey for ASC, Infection Control Surveyor Worksheet, Exhibit 351