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Emergency department ultrasound probe infection control: challenges and solutions

机译:急诊科超声探头感染控制:挑战和解决方案

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Abstract: Point-of-care ultrasound (US) has become a cornerstone in the diagnosis and treatment of patients in the emergency department (ED). Despite the beneficial impact on patient care, concern exists over repeat use of probes and the role as a vector for pathogen transmission. US probes are used for various applications, with the level of infection risk, based on the Spaulding Classification, ranging from noncritical with common practice to semicritical with endocavitary probes. To date, the most closely studied organisms are Staphylococcus aureus and human papilloma virus. Current evidence does confirm probe colonization but has not established a causative role in human infection. Based on current literature, US use during invasive procedures remains an infection control concern, but routine use on intact skin does not appear to cause significant risk to patients. Various barrier methods are available, each with indications based on extent of procedure and likelihood of contact with mucosal surfaces. Additionally, chemical cleansing methods have been shown to be effective in limiting probe contamination after use. New technologies utilizing ultraviolet light are available and effective but not widely used in the ED setting. As our understanding of the critical factors in US probe cleaning and disinfection improves, it is important to assess the challenges found in our current practice and to identify potential solutions to improve practices and procedures in infection control across the spectrum of US probe use in various applications in the ED. This article serves as a summary of the current literature available on infection control topics with the utilization of point-of-care US, and discusses challenges and potential solutions to improve the current practice of probe-related infection control.
机译:摘要:现场超声(US)已成为急诊科(ED)患者诊断和治疗的基石。尽管对患者护理产生了有益的影响,但人们仍然担心探针的重复使用及其作为病原体传播载体的作用。根据Spaulding分类,US探头用于各种应用程序,具有感染风险的级别,范围从常规的非临界型到腔内探头的半临界型。迄今为止,研究最密切的生物是金黄色葡萄球菌和人乳头瘤病毒。当前证据确实证实了探针定植,但尚未在人类感染中建立起致病作用。根据目前的文献,美国在侵入性手术中的使用仍然是感染控制的关注点,但是在完整皮肤上常规使用似乎不会给患者带来重大风险。可以使用各种屏障方法,每种方法都基于操作的范围和与粘膜表面接触的可能性而做出的适应症。另外,已证明化学清洁方法可有效限制使用后探针的污染。利用紫外线的新技术是有效的,但在ED环境中并未广泛使用。随着我们对美国探针清洗和消毒的关键因素的了解不断提高,重要的是评估当前实践中发现的挑战,并找出潜在的解决方案,以改善美国探针在各种应用领域中的感染控制实践和程序在急诊室。本文是对利用美国即时医疗服务进行感染控制主题的最新文献的总结,并讨论了改善探针相关感染控制当前实践的挑战和潜在解决方案。

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