Preparedness of Australasian emergency departments for point‐of‐care ultrasound in the COVID‐19 pandemic. Issue 4 (12th September 2021)

• Record Type: Journal Article
• Authors: Manivel, Vijay; Herbert, David G.; Kitson, Gareth Ian; Robertson, Dougal Buchanan; Basseal, Jocelyne Marie; Manion, James
• Is Part Of: Australasian journal of ultrasound in medicine. Volume 24:Issue 4(2021)
• Page Start: 187
• Page End: 207
• Publication Date: 2021-09-12
• Subjects: COVID‐19 -- emergency department -- ultrasound -- disinfection -- emergency preparedness; Ultrasonics in medicine -- Periodicals; Ultrasonic imaging -- Periodicals; Ultrasonic imaging; Ultrasonics in medicine; Periodicals; 616.075430
• DOI: 10.1002/ajum.12283
• Languages: English
• ISSNs: 1836-6864

Abstract

Abstract: Introduction: Point‐of‐care ultrasound (POCUS) has been brought to the limelight again, with a surge in lung ultrasound in suspected COVID‐19 patients. This is due to POCUS superiority over chest X‐ray, equivalent efficacy to computerised tomography chest for COVID‐19 diagnosis and potential minimisation of cross‐infection. However, inadequate disinfection practices could make ultrasound machines a vector for disease transmission. This study, conducted during the early phase of the COVID‐19 pandemic, surveyed the preparedness of Australasian Clinicians for responsible POCUS practice within the Emergency Department (ED). Methods: An anonymous online survey conducted from 20th April to 3rd June 2020 among emergency clinicians providing POCUS within Australasian EDs investigated preparedness to provide effective POCUS while minimising cross‐infection. Results: The survey received 171 responses and 116 being eligible for analysis. Most respondents (n = 96, 98%) had a separate 'hot zone' with a dedicated US device (n = 75, 77%), but lacked COVID‐19‐specific standard‐operating procedures (n = 51, 52%) or a designated safety and compliance officer (n = 36, 37%). Most clinicians (n = 86, 88%) were willing to perform ultrasound in highly infectious patients, despite poor formal training (n = 66, 67%) or COVID‐19‐specific lung protocols (n = 59, 60%). Most (n = 92, 93%) had access to appropriate low‐level disinfectant wipes but varied significantly in disinfection practice due to a lack of timely, formal or unified guidelines. Conclusion: Australasian EDs significantly lacked investment in education, training and protocols to conduct safe POCUS in the COVID‐19 pandemic. A framework with evidence‐based, logistically feasible protocols supporting safe emergency POCUS is required to deal with similar future infectious outbreaks.