Evaluation of emergency department ultrasound machines for the presence of occult blood

Poonja, Zafrina; Uppal, Jasmene; Netherton, Stuart J.; Bryce, Rhonda; Lyon, Andrew W.; Cload, Bruce

doi:10.1017/cem.2018.447

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Some hospitals have yet to implement any cleaning protocol for ultrasound procedures. The American Institute of Ultrasound in Medicine recently introduced new guidelines intended to ensure appropriate level or transducer preparation based on the examination type. A review of the current literature and data from our study support these guidelines.…”

Section: Discussionmentioning

confidence: 99%

Identification and Analysis of Bacterial Contamination of Ultrasound Transducers and Multiuse Ultrasound Transmission Gel Bottle Tips Before and After the Aseptic Cleansing Technique

Mullins

Burnham

Henricson

et al. 2020

J of Ultrasound Medicine

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Objectives-To provide a descriptive analysis for species identification of culture and Gram stain results from ultrasound transducers and multiuse ultrasound transmission gel bottle tips in active clinical use and to compare bacterial cultures from ultrasound transducers before and after aseptic cleansing. Methods-A prospective blinded descriptive analytic study of 18 distinct clinical care sites within a single primary clinical institution was conducted. Before and after a disinfectant towel cleanse, transducers were pressed against tryptic soy agar contact plates. Plates were deidentified and submitted for blind incubation, Gram staining, and species identification with microsequencing. Results were classified as clinically relevant (CR) or non-clinically relevant. In total, 188 samples were analyzed: 80 from ultrasound transducers before and cleansing, 13 from multiuse gel bottle tips before and after cleansing, and 2 precleansing samples from the data collector's pen and badge. Results-Fifty-nine precleansing samples (73.8%) grew cultures with CR bacteria, and 21 samples (26.3%) did not. Staphylococcus simulans represented 31.0% of all positive culture samples. Thirteen postcleansing samples (16.3%) grew cultures with CR bacteria, equating to a 78.0% reduction of CR bacterial growth (likelihood ratio, 57.10; P < .001). Conclusions-Ultrasound transducers have a notable CR bacterial burden and may serve as potential infective vectors. Aseptic cleansing effectively eliminates most of the bacterial load from ultrasound transducers, but some bacteria persist, presenting a risk of nosocomial infection with ultrasound-guided interventions. These findings support American Institute of Ultrasound in Medicine 2018 guidelines intended to ensure an appropriate level of transducer preparation based on the examination type while emphasizing rational infection control measures to minimize the risk of potential patient harm.

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Section: Discussionmentioning

confidence: 99%

Identification and Analysis of Bacterial Contamination of Ultrasound Transducers and Multiuse Ultrasound Transmission Gel Bottle Tips Before and After the Aseptic Cleansing Technique

Mullins

Burnham

Henricson

et al. 2020

J of Ultrasound Medicine

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Shocked, breathless, and bloodied: Point-of-care ultrasound on the front line

Atkinson

Lewis

2019

CJEM

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Point-of-care ultrasound (PoCUS) has come a long way since the days when ultrasound was a hidden dark art, only practised deep inside the recesses of radiology departments. The transition of the use of this technology from the assessment of relatively stable patients, into a tool used by front line clinicians has been proceeded steadily, to the point where many now consider PoCUS to be standard of care, much like the stethoscope, when assessing patients clinically. 1 In this issue of CJEM, three groups of authors tackle questions related to the use of PoCUS on the front line of emergency medicinein the resuscitation room. The use of PoCUS in undifferentiated hypotensive, or shocked, patients has evolved from the targeting of specific individual pathologies and etiologies, to the development of systematized PoCUS protocols designed to answer physiological questions, identify pathology, and guide resuscitation. 2-4 Stickles et al. looked at how reliable one of the most popular and commonly used of these protocols, the Rapid Ultrasound for Shock and Hypotension (RUSH) protocol, is in terms of accurately identifying the underlying category of shock in hypotensive patients. 4,5 Jones et al. previously reported that early use of a similar PoCUS protocol helped narrow the differential diagnosis when compared with delayed use, in one of the first comparative studies of PoCUS. 2 In their analysis, Stickles et al. performed a systematic review and meta-analysis of the literature, focusing on diagnostic studies for RUSH. 5 This well-done analysis included four relevant studies totalling 357 patients. With sensitivities ranging from 64% for distributive, to 93% for obstructive shock, and specificities ranging from 80% for mixed, to 98% for obstructive, they concluded that when used in isolation, the RUSH

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Evaluation of emergency department ultrasound machines for the presence of occult blood

Cited by 2 publications

References 8 publications

Identification and Analysis of Bacterial Contamination of Ultrasound Transducers and Multiuse Ultrasound Transmission Gel Bottle Tips Before and After the Aseptic Cleansing Technique

Identification and Analysis of Bacterial Contamination of Ultrasound Transducers and Multiuse Ultrasound Transmission Gel Bottle Tips Before and After the Aseptic Cleansing Technique

Shocked, breathless, and bloodied: Point-of-care ultrasound on the front line

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