Ultrasound checklist from the ISRRT Response Document

Site: ISRRT e-Learning
Course: Practical guidelines for radiographers/radiological technologists during the pandemic COVID-19
Book: Ultrasound checklist from the ISRRT Response Document
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Date: Thursday, 24 September 2020, 11:44 AM

1. Preparation, during and post procedure precautions

Introduction: 

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. Sonographer / Sonologist / echo tech

  • Imaging requests should be triaged scan, can be delayed without impacting on clinical care or can be avoided until after the pandemic. 
  • As per generic advice on PPE for all in close contact, remembering that sonography involves prolonged physical contact, often in a confined space.  
  • Attempt to shorten the duration of the examination by arranging for the most experienced Sonologist / sonographer to perform the examination (ISUOG, 23.03.20)
  • Fetal anomaly screening programmes are time critical and we should continue to offer timely screening.  (RCOG guidance 24.3.20). In the event that there is insufficient staff to provide the service, scans should be prioritised in the following order: 
1. Anomaly scan at 18+0 -23+0 weeks 

2. Ultrasound +/- screening at 11+2 14+1 

3. Growth scans 




1.2. Patient considerations

  • As per generic advice – patients with COVID-10 to wear mask. 
  • Schedule known Covod19 patients last on list or last in day. 
  • Patients should be asked to attend alone 
  • Inform the patient that a detailed explanation will not be given during the examination (ISUOG, 23.03.20)

1.3. Equipment considerations

  • As per generic advice. 
  • Set aside dedicated COVID-19 room / equipment / mobile / probe(s). 
  • After use with each COVID-19 patient, clean all equipment in line with the principles and advice on couch cleaning in the Appendix. Remove all probes from the unit except the ones needed for the examination when performing exams mobile or in the designated exam room in order to avoid the necessity of high-level disinfection in the event the patient coughs or sneezes within the designated distance.

1.4. Imaging room or mobile equipment

As per generic advice

  • Set aside dedicated COVID-19 room / equipment / mobile / probe(s). This should be a room with air exchange of 6 exchanges per hour (WHO guidance, PHE 6.4.20
  • Use of single-use gel packs is recommended as opposed to refillable gel containers (ISUOG, 23.03.20). 
  • Consider probe cover for non-endoluminal probes (this is not a CDC absolute requirement (ISUOG, 23.03.20)). 
  • After use with each COVID-19 patient, clean all equipment in line with the principles and advice on couch cleaning in the Appendix.

1.5. Ultrasound general advice

  • Note that screening procedures are or may be paused, with the exception of time-sensitive procedures within Fetal Anomaly Screening programmes. 
  • Consider rescheduling non-urgent examinations 
  • Designate a waiting area which should be set up to adopt international guidelines for social distancing of at least 1 meter (3 feet) minimally or whenever possible adapt to local or national guidelines i.e. 2 meters (6 feet). 
  • Designate a specific Ultrasound room and machine and probes for use COVID-19 units 
  • Allow time between appointments for decontamination of the US system and room 
  • Single use ultrasound gel sachets should be considered for patient suspected or having COVID-19 
  • Cover probe with dedicated probe covers before procedure
  • High level disinfection of any probe used to perform the examination on a COVID-19 infected 
  • Remove all probes from the unit except the ones needed for the examination when performing exams mobile or in the designated exam room in order to avoid the necessity of high-level disinfection in the event the patient coughs or sneezes within the designated distance 
  • Separate in-patients on the ward from out-patients 
  • If staffing levels impact on obstetrics and gynaecology scanning services, the International Society of Obstetrics and Gynaecology (ISUOG) provide guidance which can be used to prioritise patients. These include 
o Early pregnancy 
o Routing and specialist obstetric scans 
o Gynaecology 


  • Routine practice is to scan with one hand and annotating with the other to keep clean glove 
  • Follow manufacturer’s recommendation for decontamination ultrasound system 
  • Waiting areas should be set up for international guideline for social distancing of at least 1 m (3 feet) or adapt best practice of local and national guideline 
  • Consider performing examinations using mobile unit in the patient’s room 
  • Droplet Precautions considered for Treadmill or Bicycle stress echocardiograms which should be changed to pharmacological stress echo (due to patient coughing during test) 
  • Considered Aerosol Precautions use of PAPR recommended for Transthoracic echocardiograms (TOE) using a sterile Probe cover