Nathan Peters1,2, Frances Williamson2,3, Victoria Eley1,2
1Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women’s Hospital, Brisbane, Australia, 2Faculty of Medicine, The University of Queensland, Brisbane, Australia, 3Emergency and Trauma Centre, Royal Brisbane and Women’s Hospital, Brisbane, Australia
Correspondence: n.peters@uq.edu.au
Abstract
There are varying international recommendations regarding the minimum level of disinfection required for ultrasound transducers used in percutaneous procedures. While some guidelines recommend high-level disinfection, others question the additional benefit this delivers over low-level disinfection. This narrative review identifies current guidelines and evaluates the evidence used to support disinfection recommendations for ultrasound transducers used in percutaneous procedures. Thirteen guidelines were identified between 1st January 2013 to 31st January 2024. No guidelines were supported by high-quality evidence, instead guidelines relied upon: expert opinion through the application of national standards and infection control principles; consideration of recommendations from other published guidelines; and the incidence of infection from retrospective studies. Guidelines were uniformly supportive of using ultrasound transducer covers and sterile ultrasound gel. However, the minimum recommended disinfection level was varied with seven guidelines recommending HLD, four LLD, and two not specifying a level. Without high-level evidence, using a risk-based assessment will likely remain fundamental to future guideline recommendations in determining the minimum disinfection level for an ultrasound transducer used in percutaneous procedures. This risk assessment must include the highest level of evidence available in addition to acknowledging the contribution of all steps taken to prevent infection during ultrasound guided percutaneous procedures.