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Hygiene - Pflege Ultraschallgeräte und Ultraschallsonden | Praxis für Pränatalmedizin Darmstadt - Prof. Scharf

Hygiene – Pflege Ultraschallgeräte und Ultraschallsonden

– 2016-04 E. Merz: Ist die Schallkopfhygiene beim Einsatz von Vaginalsonden in der gynäkologischen Routine ausreichend? 

– 2014-07 Häggström M, Spira J, Edelstam G: Transducer hygiene: Comparison of procedures for decontamination of ultrasound transducers and their use in clinical practice

– Schweizer Gynäkologische Ultraschall-Richtlinie (Swiss Gynaecologic Ultrasound Guideline, 2nd Edition): "Particular attention should be paid to hygiene when carrying out TVS. The ultrasound practitioner should wear gloves. The TVS probe is covered with a uniform gel-filled rubber sleeve. A sterile lubricant is applied to the outside (N.B.: allergies to rubber components, e.g. latex allergy and lubricants). Condoms are preferably used since they are more resistant than standard ultrasound sleeves. In terms of infection, the vaginal mucosa can be likened to abraded skin and is thus prone to an increased risk of infection. Thorough decontamination after every examination is essential to prevent infection via bacterial spores, mycobacteria and fungi. The most effective procedure is to wash the probe with soap and water, rinse with water and dry. 99% of bacterial colonisation is already eliminated by using soap. In addition, the probe should be immersed in glutaraldehyde for 20 minutes and subsequently rinsed and dried. This is recommended because 2 % of condoms are not leak-proof. In 66 % of cases, the non-leak-proof area is in the region of the probe tip and can easily be identified by wiping with a dry paper towel. The TAS probe and the mammary probe should always be disinfected after use. In 17.5 % of cases, bacterial contamination persists if the probe is just wiped. If a disinfectant is used, a 2 % level of contamination persists. Ultrasound gel is another source of contamination. Gel should only be used with small bottles that are changed/disinfected daily."

– 2012-12 Government of Western Australia – Department of Health: Prevention of cross infection in diagnostic ultrasound: "Studies have shown that there is some risk of microbial transmission during ultrasound examination procedures. The risk is significantly increased with the use of intracavity transducers and /or where blood and body fluids are encountered. To prevent or minimise the risk of infection, Standard Precautions should be adhered to at all times when patient care is provided. Every patient is regarded as a potential source of infection and therefore appropriate precautions should be taken to minimise the risk of cross-infection. Standard precautions that should be undertaken as part of every examination include:  Hand hygiene before and after each examination, use of personal protective equipment where appropriate, maintenance of clean and/or disinfected patient equipment, maintenance of clean working environment, correct disposal of waste."

Reinigung der TAS: 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. 

Reinigung der TVS: Cleaning of the transducer prior to disinfection is crucial as it reduces the microbial load making the disinfection process more effective. On completion of an ultrasound examination, all gel and extraneous material should be removed from the transducer using running water. Use a small, soft brush to clean any crevices or angles, being careful to avoid the elements at the probe face. All intracavity transducers must then undergo high level disinfection as a minimum standard. Only chemicals registered with the Therapeutic Goods Administration (TGA) as high-level instrument grade disinfectants for class IIb medical devices are to be used for intracavitary ultrasound 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. All solutions used must be a labelled instrument grade high level disinfectant. 

– 2010-07 B. Sahu and N. Raine-Fenning: Ultrasound and the risk of nosocomial cross infection, Ultrasound in Obstetrics & Gynecology, Volume 36,  Issue 2, pages 131–133, August 2010

– 2005-02 E. Merz: Transducer hygiene — an underrated topic? – Schallkopfhygiene – ein unterschätztes Thema?