How minimise the risk of contagion during patient contact

1. How minimise the risk of contagion during patient contact

All patients should wear a surgical mask during radiological examinations and, if the patients are to be transported to the radiology department for the examination, they must also wear a surgical mask during transport to and from the department (if tolerated).¹ ^,2

From the Italian experience with novel coronavirus disease (COVID-19), to decrease the viral load present on imaging devices, radiographers should:

Wear a third pair of gloves before touching patients and anything around them;
Remove the third pair of gloves and perform an alcoholic gel hygienization before touching the machine, and after each contact with patients or with their surroundings;
To avoid being in the trajectory of any droplets, they are advised not to simulate inspiratory apnoeas while remaining in front of the patient.

When dealing with cooperative patients:

Radiographers can demonstrate body positioning and how to perform correct breath holds while remaining at a safe distance. The use of an intercom system may be beneficial.

When dealing with non-cooperative patients:

In case of chest CT scans, radiographers should seek help from another member of the healthcare staff, properly dressed and with specific personal protective equipment (PPE). The second operator should move patients on the CT safety couch using a roll covered with a disposable plastic coverage;

To accompany patients in and out the CT scan room, the presence of another member of healthcare staff, properly dressed, with specific PPE, is suggested.

If necessary, radiographers assigned to perform imaging on COVID-19 patients may collaborate with another healthcare worker member for optional matters.

In case of portable chest X-rays for bed-ridden patients (not in the intensive care unit), to speed up the procedure and reduce the time spent in a higher risk environment, the presence of a second radiographer who handles the portable machine is suggested
It could be useful to get help from the ward staff when positioning the plate under the patient.

Radiographers should give indications to the patient about body and arms positions and about how to hold breath from a distance. If necessary, the radiographers should ask for help to one member of the healthcare staff of the ward, properly dressed, with specific PPE.

According to AAPM Position Statement on the Use of Patient Gonadal and Fetal Shielding,³ as radiation doses used in diagnostic imaging are not associated with measurable harm to the gonads or fetus, patients gonadal and fetal shielding during X-ray based diagnostic imaging should be discontinued.

Furthermore, to avoid the use of shielding might reduce adjunctive close contacts with patients preventing transmission amplification events.