The importance of high-level disinfection of ultrasound probes in the Emergency Department

Mr Aryan Shahabi-sirjani¹, Mr Andrew Gibb¹, Dr Jonathan Burdach¹

¹Nanosonics, Macquarie Park, Australia

Emergency departments (ED) are the most complex health care delivery environments. Procedures are often performed under time pressure, with patients being of unknown infectious status. Ultrasound is increasingly used in invasive procedures and to guide a variety of interventions for these patients.

Healthcare-associated infections (HAIs) are the most frequently occurring medical adverse event worldwide, causing significant risks to patients and staff. With frequent ultrasound use in the ED, adequate cleaning and disinfection is necessary to ensure probes are ready for safe use.

Spaulding classification is used by the Australian Guidelines for the Prevention and Control of Infection, AS/NZS 4187 and ACIPC-ASUM guidelines, to determine the level of disinfection required. High level disinfection (HLD) should be used when a probe contacts broken skin or mucous membranes and when the probe contacts sterile tissue in conjunction with a sterile sheath if sterilisation is not possible. According to these guidelines the use of a protective barrier does not change reprocessing needs, and merely acts as additional mechanism to reduce infection risk.

Both endocavitary ultrasound examinations and ultrasound guided procedures using external probes are performed in ED. Endocavitary probes always contact mucous membranes and consequently always require HLD and use with a sheath. External probes may come into contact with a variety of patient sites and should be adequately disinfected before patient use in those applications.

It is important to correctly apply Spaulding and follow Australian Standards on the reprocessing of semi-critical and critical probes to keep patients safe from HAI.

Biography: Aryan is an infectious diseases clinical pharmacist, serving as global Medical Affairs Manager at Nanosonics. He has a breadth of experience in infection prevention and control, antimicrobial stewardship and clinical infectious diseases and microbiology.