Article of the Month – May 2020

ASE Statement on Protection of Patients and Echocardiography Service Providers During the 2019 Novel Coronavirus Outbreak

Endorsed by the American College of Cardiology

URL: https://www.asecho.org/wp-content/uploads/2020/03/COVIDStatementFINAL4-1-2020_v2_website.pdf

DOI: DOI: 10.1016/j.jacc.2020.04.002

Published: Journal of the American College of Cardiology (2020)

Contributors: James Kirkpatrick, MD, FASE (Chair), Carol Mitchell, PhD, ACS, RDMS, RDCS, FASE, Cynthia Taub, MD, FASE, Smadar Kort, MD, FASE, Judy Hung, MD, FASE, Madhav Swaminathan, MD, FASE

Article Description:

  • This document addresses triaging and decision pathways for handling echocardiographic requests, as well as indications and recommended procedures to be followed for an echocardiographic assessment of cardiovascular function in suspected or confirmed COVID-19 cases

Summary:

  • ASE is committed to the health, safety and wellbeing of the staff and patients.
  • Echocardiographic exams be planned ahead, based on indications, clinical information, laboratory data and other imaging findings to allow for a focused sequence of images that help with management decisions.
  • Limit the number of echocardiography practitioners involved in scanning with excluding high-risk staff.
  • Scan times should be minimized by excluding students or novice practitioners from performing imaging.
  • Imaging team should ensure rapid review and reporting of key findings in the patient’s record and communicating them with the primary care team.
  • Personal Protection Equipment (PPE) includes
  • Handwashing or hand sanitization.
  • Use of gloves.
  • Use of a surgical face mask.
  • Droplet precautions include gown, gloves, headcover, facemask and eye shield.
  • Airborne precautions add special masks (e.g. N95 or N99 respirator masks, or powered air purifying respirator systems), and shoe covers.
  • Equipment protection: Covering probes and machine consoles with disposable plastic should be balanced against the risk of potential for suboptimal images and prolongation of scan time.

Conclusions:

  • In conclusion, the provision of echocardiographic services remains crucial in this difficult time of the SARS- CoV-2 outbreak. Efforts should be exerted to provide high quality care while minimizing risk to staff, patients and the public. Carefully considering ‘Whom to Image’, ‘Where to Image’ and ‘How to Image’ has the potential to reduce the risks of transmission.
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