With infection control a prominent issue for those involved in medical ultrasound practice, ACEM has released a statement on the issue.
FACEM Dr Alistair Murray, Chair of the Emergency Department Ultrasound Committee, said ACEM recognised that the Australasian Society for Ultrasound in Medicine (ASUM) has produced a consensus guidance document with an aim to assist in guiding practitioners in respect to best practice.
“Unfortunately, the ASUM guidance document is felt to be unreasonably restrictive and risks unintended patient harm, resulting from the significant restriction to the use focussed ultrasound in clinical practice,” Dr Murray said.
“The released ACEM statement is in line with guidance produced by the American College of Emergency Physicians (ACEP) and the American Institute for Ultrasound in Medicine (AIUM).
“ACEM intend to continue to work toward collaborative evidence with ASUM in order that best care can be provided to our patients.”
ACEM position
ACEM’s positon on cleaning and disinfection of ultrasound transducers that are used for needle-based procedures is:
ACEM recognises that current infection control processes for ultrasound machines and transducers in EDs may require change as further evidence becomes available. To this end, ACEM is actively working with ASUM and ACIPC to better determine processes and standards to ensure the provision of the best possible patient care. ACEM also recognises that improvements to current practice is required.
Ultrasound is a key element in guiding and improving safety of procedures in emergency medicine.
Internationally accepted guidelines specifically recommend the use of ultrasound for certain procedures, e.g. central vascular access.
ACEM is concerned that the requirement for the combination of both sterile probe covers and HLD for procedures (e.g. needle guided procedures) may be unnecessary. This intervention has unclear incremental benefit over the use of a sterile probe cover and LLD performed both before and after a procedure.
ACEM is concerned that the logistics of rigidly implementing this guideline could threaten the provision of a meaningful point of care ultrasound service. The use of ultrasound to guide clinical procedures has clear established patient benefit in the medical literature.
Current literature is limited as to the actual infection risk posed by transducers that are used to guide needle-based clinical procedures through skin. Most reports of infection relate to scanning across mucus membranes or via contaminated gel. To this end, ACEM commits to actively collaborate with ASUM in an attempt to better quantify risks and guide best practice.
The statement also provides a number of recommendations, with emergency physicians urged to use all practical measures available to them to minimise cross-infection risk.
“Hospital infection control services should direct their efforts towards assisting clinicians and ensuring the seamless provision of service rather than restriction of that service,” the statement says.
