Here’s the 30min COVID_IMBUS talk given to the residents and hospitalists today if you missed it.
To clarify a couple questions that arose in both groups…
· Once the machine is isolated to a cohorted all-COVID+ unit (not mixed PUI/COVID+) and there is not a risk of moving COVID from an infected patient to a potentially non-infected patient, the providers are in continuous PPE, and the machine doesn’t need to use probe covers, and can just be wiped down outside of the room as it would with normally with contact precautions (i.e. Oxivir wipe). The same would go with a tablet ultrasound machine in that environment.
· This protocol discussed in the video is meant for devices moving between COVID+/PUI patients and other PUI or other non-COVID/PUI patients where there is a risk of bringing COVID to someone that may not or doesn’t have COVID.
· Please remove the SonoSite EDGE laptop from the cart when using outside of a cohorted all-COVID+ unit as it is much easier to run through the disinfection protocol off the stand. Please watch this video before doing it so you don’t break off the rear pins. The machine must be seated in the dock on the cart after the exam to charge and to connect to WiFi if you want to upload a study or send so someone can review it on Tricefy.
· The steps for disinfecting a tablet fully enclosed in a sleeve as in this video OUTSIDE of a continuous covid+ only environment would be:
o While still in the COVID/PUI room in your PPE foam your gloves, remove the rubber bands and any gel on the sleeve, wipe down the entire outside of the sterile sleeve enclosing the device w Oxivir
o Set the draped device outside of the room after cleaning the entirety of the sleeve as above
o Take off dirty PPE
o Put on clean gloves outside of the room
o Remove the tablet from the cleaned sleeve and wipe down one final time with Oxivir being careful not to pool water on the sensitive parts of the tablet.
The biggest clinical roles will be
1) a patient that is being considered for moving out of PUI status either before a PCR returns, or in the setting of worrisome timeline and clinical story with a potential false negative PCR (~30+%). If lung findings without alternate explanation should be cautious about stopping precautions and discuss with ID +/- repeat test after consultation with them.
2) In a patient with known Covid and pulmonary infiltrates already known on imaging who clinically decompensates and there is worry for cardiac involvement, pneumothorax, etc.
3) I don’t think there is much use for daily monitoring of pulmonary infiltrates beyond the other clinical markers of worsening/improving
Again, the resources for sending images for review, putting a sleeve on the lumify, removing the EDGE from a cart, etc are at https://imbus.anwresidency.com under the resources tab at the top.