Wednesday, 10 May 2017

PREVENTION OF CROSS INFECTION IN DIAGNOSTIC ULTRASOUND



The risk of microbial transmission during ultrasound examination procedures by increased with the use of intracavity transducers and /or where blood and body fluids are encountered.

Standard precautions should be taken to minimise the risk of cross-infection.

  •  Hand hygiene before and after each examination
  •  Use of personal protective equipment 
  •  Maintenance of clean and/or disinfected patient equipment
  •  Maintenance of clean working environment
  •  Correct disposal of waste
Classification of infection risk

Critical

These items confer a high risk for infection if they are contaminated with any microorganism and must be sterile at the time of use.

Semi-critical

These items come into contact with mucous membranes or non-intact skin, and should be single use or sterilised after each use.High level disinfection is also acceptable

Non-critical


These items come into contact with intact skin but not mucous membranes.Clean or low level disinfection is sufficient for most non-critical items after each individual use.


Cleaning and disinfection

  •  All transducers that are likely to come into contact with broken skin
  •  All intracavitary transducers (for example, transvaginal, transrectal, transoesophageal)
  •  All transducers used during ultrasound-guided biopsy or infiltration
  •  All transducers used in ultrasound-guided interventional procedures
  •  All transducers used within a sterile environment (such as operating theatres)

1. TRANSABDOMINAL ULTRASOUND



To minimise cross infection the following is required:


1.Hand hygiene


  • Hand hygiene must be performed before and after each patient contact.


2. Cleaning of the ultrasound transducer



  • After each use, remove coupling gel from probe by wiping with a soft cloth and wash the probe with surface in lukewarm water and mild detergent with a soft sponge, gauze or cloth, removing all visible residue. 
  • Do not use harsh detergents or abrasive cleaners.
  • Rinse thoroughly in flowing water to remove all detergent residues. 
  • Air dry or dry with a soft cloth.
3. Patients with wounds and/or abrasions



  • A disposable transducer cover should be used.
  • In event of blood or bodily fluid contamination, the protocol for probes used for intracavity ultrasound applies.

2. INTRACAVITY ULTRASOUND



In general, intracavity ultrasound poses an increased risk of cross-infection compared to transabdominal scanning.
The following scanning procedures carry significant risk of cross infection due to contact with mucous membranes and/or blood or body fluids.


  • Transvaginal
  • Transrectal
  • Intracavity and wound
  • Transoesophageal


To minimise cross infection the following is required:

  1. Hand hygiene
  2. transducer cover
  3. Cleaning

Disinfection of the intracavity ultrasound transducer


  • high-level instrument grade disinfectants for class are to be used for intracavitaryultrasound transducers and these include
  • Ortho-phthalaldehyde (OPA) 0.55%
  • Gluteraldehyde 2%
  • Hydrogen Peroxide, used with the Trophon EPR System
  • Peracetic Acid, as in STERIS system
  • Chlorine Dioxide, used with the Tristel wipes system

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