Mobile X-ray equipment

3. Safe use and Infection Control

A multidisciplinary panel comprised mainly by radiologists and pulmonologists with experience managing COVID-19 patients evaluated the utility of imaging considering the variation of risk factors, community conditions and resource constraints (8). This group of experts considered that chest radiography (CXR) and computed tomography (CT) are important in this scenario except on patients with mild clinical features unless they are at risk for disease progression. CXR are performed daily in many intensive care units but there are studies showing evidence of the limited efficacy of this type of examination even outside the COVID-19 setting (9, 10, 11). The examination is useful for COVID-19 patients but if they present severe conditions and if they are well justified.

However, to perform any type of imaging there is a need for strict adherence to infection control protocols designed to minimize risk of transmission and protect healthcare personnel(8)

The protection of professionals varies according to each country but Centers of Disease Control (CDC) guidelines recommend radiology staff wear a mask, goggles or face shield, gloves, and an isolation gown at least. According to the Radiology Scientific Expert Panel(12), the main strategies to work safely in this scenario consider the decontamination of the equipment and the rooms used to imaging positive patients for COVID-19 (Table 2).

Table 2 – Radiology Preparedness for COVID-19 pandemic (adapted from Radiology Scientific Expert Panel (12))

Outside the radiology department, when mobile equipment for chest x-rays is used with COVID-19 patients is also necessary to perform decontamination before its use in other patients to avoid the spread of disease. Appropriate manipulation involves a minimum contact with the different components of the equipment namely to the x-ray tube, detector and console for exposure parameters selection. The detector should be protected with the available materials at the intensive care unit. After the verification of the image, the equipment should be removed from the room to be clean with an appropriated agent to not damage the equipment (mobile x-ray and the detector itself).