Computed Tomography Checklist in 3 stages

Site: ISRRT e-Learning
Course: Practical guidelines for radiographers/radiological technologists during the pandemic COVID-19
Book: Computed Tomography Checklist in 3 stages
Printed by: Guest user
Date: Friday, 1 March 2024, 5:15 AM

Description

This section has been extracted from the “ISRRT Response Document-appropriate and safe use of Medical Imaging and Radiation Therapy with infection control measures considered in addition to standard radiation protection procedures. April 2020”. It is available on the ISRRT Website (https://www.isrrt.org/full-guideline-protective-measures). It is edited and compiled by A.Stewart Whitley, Director of Professional Practice - International Society of Radiographers and Radiological Technologists(ISRRT) following valuable input from many radiography expert contributors.

1.1. Radiographer/RT Tasks

  • Ensure that patients and staff use the central entrance and do not enter the department without permission and without specific reason.
  • Do not allow asymptomatic patients to wait in the waiting room with suspected confirmed COVID-19 patients.
  • Have them wait in a separate designated room.
  • Maintain WHO social distancing or 2meters (6 feet).
  • Confirm that medical exposure has been justified as urgent accordingly and/or cannot be rescheduled
  • Inform the referring physician that the patient would not be allowed to enter the department and examination room unless wearing the appropriate mask in accordance with the Infection Prevention Committee guidelines.
  • Ensure areas and equipment have been adequately disinfected-decontaminated.
  • Disinfect - wash hands.
  • For asymptomatic- suspected COVID-19 patients wear a simple surgical mask and single use gloves when receiving a paper referral, identify the patient and continue with the procedure.
  • For confirmed COVID-19 patients, don a N95/FFP2/FFP3 mask for Aerosol Generating Procedures (AGP) and single use gloves, full face mask when available or goggles and a fluid resistant isolation gown
  • When receiving a paper referral, identify the patient and continue with the procedure

1.2. Patient Considerations

  • Controlled arrival and departure of patients and staff in the radiology department and only using the central entrance
  • Patient to wear mask

    1.3. Equipment Considerations

    Disinfection-Decontamination with the use of appropriate technique and means according to Hospital Infectious Diseases Control Committee between patients depending on their infection status (i.e. asymptomatic-suspected-confirmed COVID 19):

    • CT SCANNER (immobilization straps, positioning sponges)
    • Automatic Contrast Medium Injector (consumables-syringes, tubing, IV connectors)
    • Auxiliary equipment (i.e. ECG, Defibrillator, suction device, Oxygen mask)

    1.4. Imaging Room Environmental Considerations

    • Disinfection-Decontamination with the use of appropriate technique and means of areas and patient contact surfaces according to Infection Protection Committee between patients depending on their infection status (i.e. asymptomatic-suspected-confirmed COVID 19)
    • Sufficient air ventilation
    • Appropriate room temperature

    2.1. Radiographer/RT Tasks

    • Ensure that the wheelchair or stretcher is removed from the examination room
    • Cover the CT couch with disposable paper
    • Remove any metallic objects in the region of ​​interest from the patient with particular care (especially artificial dentures, nose rings, where there is risk of being infected).
    • Remove gloves and dispose of them in the Clinical Waste bin (hazardous-contaminated waste) in accordance with the regulation of your Hospital Waste Management Committee. (HWMC)
    • Remember, when exiting the CT scanner room (contaminated area) clothing may be contaminated.
    • Don't remove your mask!
    • Disinfect hands with a hand sanitizer before you enter the CT console area (clean area) i.e. before touching the keyboard and mouse, the control console, and the injector.
    • Perform examination (i.e. scanning and IV CM injection) in consideration of the diagnostic requirements and the principles of justification, optimization, radiation dose limitation as well as the Radiographer’s/Radiological Technologist’s Ethical Code and RG/RT Professional Rights at all times.

    2.2. Patient Considerations

    Patient to wear mask

    2.3. Equipment Considerations

    • CT Gantry controls and CM injector control screen keys are considered contaminated so they must be used with gloves
    • CT couch is covered with single use paper per patient.
    • CT console keyboard, mouse and exposure pad as well as the CM injector remote control panel are considered clean so they must be used without gloves
    • CM injector control panel may be covered with a disposable plastic cover.

    2.4. Imaging Room Environmental Considerations

    • Sufficient air ventilation
    • Appropriate room temperature

    3.1. Radiographer/RT Tasks

    • When entering the CT scanner room (dirty area), wear disposable gloves.
    • Carefully remove the used paper cover from the CT couch without touching your clothing and dispose of it in the corresponding bin according to hospital policy.
    • Ensure decontamination-disinfection of CT couch-gantry keypad, CM injector control panel and surfaces / contact points (sponges, fixing pads, knobs) by the use of a suitable disinfectant in accordance to Infection Prevention Committee and CT manufacturer’s instructions.
    • After disinfection/decontamination/deep cleaning, the RG/RT must visually inspect the scanning area, CT scanner and auxiliary equipment with gloves and mask.
    • Carefully remove your gloves FIRST, keep mask on!
    • Dispose of them in the Clinical Waste bin (yellow hazardous contaminated waste) in accordance with the regulation of your HWMC
    • Disinfect hands immediately as there is danger of being contaminated without gloves!
    • Remove mask carefully so that the cords or bands of the mask do not touch the face or mucous membranes of the face (and eyes) and dispose of it in the Clinical Waste bin (hazardous contaminated waste) in accordance with the HWMC.
    • Disinfect - Wash hands well (again because you touched your mask)!

    3.2. Patient Considerations

    Patient to wear mask

    3.3. EquipmentConsiderations

    • When entering the CT scanner room (dirty area), wear disposable gloves.
    • Carefully remove the used paper cover from the CT couch without touching your clothing and dispose of it in the corresponding bin according to hospital policy.
    • Ensure decontamination-disinfection of CT couch-gantry keypad, CM injector control panel and surfaces / contact points (sponges, fixing pads, knobs) by the use of a suitable disinfectant in accordance to Infection Prevention Committee and CT manufacturer’s instructions.
    • After disinfection/decontamination/deep cleaning, the RG/RT must visually inspect the scanning area, CT scanner and auxiliary equipment with gloves and mask.
    • Carefully remove your gloves FIRST, keep mask on!
    • Dispose of them in the Clinical Waste bin (yellow hazardous contaminated waste) in accordance with the regulation of your HWMC
    • Disinfect hands immediately as there is danger of being contaminated without gloves!
    • Remove mask carefully so that the cords or bands of the mask do not touch the face or mucous membranes of the face (and eyes) and dispose of it in the Clinical Waste bin (hazardous contaminated waste) in accordance with the HWMC.
    • Disinfect - Wash hands well (again because you touched your mask)!

    3.4. Imaging Room Environmental Considerations

    • Disinfection-Decontamination-Deep cleaning of:
      • surfaces
      • contact points (knobs) by the use of a suitable disinfectant in accordance to Infection Prevention Committee
    • In case of contamination i.e. if patient mask is removed during a procedure or during an Aerosol producing procedure, ensure that the CT unit examining room is disinfected accordingly after 30 min and ventilated adequately for 30-60 minutes following the disinfection/decontamination procedure (based on local practice recommendation) before the next examination.
    • Attention to door knobs, keyboards, console, mouse, phone, mobile phones, pagers, lighting switches, as they are also contaminated.
    • CT areas must be decontaminated at the beginning of each work shift