COVID19: US Cleaning Guidelines

Point of Care Ultrasound Taskforce (POCUS-T):

Recommendations for POCUS use during the COVID-19 Pandemic.

The POCUS-T understands that all POCUS applications may be of perceived benefit during the COVID-19 pandemic to assist with diagnosis, treatment and prognosis. We want all operators to use extreme caution because the device surfaces can act as a fomite for the spread of SARS-CoV-2. We offer the following recommendations for current use:

All Machines/All Units:

Immediately: Remove all unnecessary equipment from the machine and wipe down machine surfaces following routine procedure (many devices have attached “saddle bags” or containers where gel, IVs, probe covers, reference material are held–remove these to make cleaning easier) (ACEP EUS/CUAP Advice).

Dispose of any currently open US probe bottles, only use single packet sterile US gel or lubricant jelly

All Machines/All Units: Common BJC Cleaning Wipe Information

Current common wipes that have clear instruction are collectively known as the “orange top, purple top, green top, and grey top.” In terms of “wet time” (the time the probes should be left unused after a thorough wipe) orange is the fastest (1 minute), followed by purple (2 minutes), followed by grey (3 minutes). See the table below for further details.

Red and Green top wipes have no up to date information on coronavirus at this time.

Be aware that some manufacturers have specific recommendations regarding which wipes are approved for cleaning.

Unit/ Patient specific information

COVID-19 Units (Mainly ICU)

These units should dedicate a single machine for use. Once identified the US machine should NOT leave the unit until further notice.

  1. Wipe down the probe and cord with the “orange top” cleaner after each use (ACEP EUS/CUAP)
  2. Use a sheath to cover the probe for each use (Am.Soc.Anes)
  3. Cover the nonessential machine surfaces with a disposable towel or sheet (Am.Soc.Anes)
  4. After use wipe down entire machine just outside of the room and be as thorough as possible. After appropriate wet time, wipe down the entire machine again. (Italian experience)
High Risk COVID-19 patient in other units (ED)
  1. Wipe down the probe and cord with a proper disinfectant after each use (ACEP EUS/CUAP)
  2. Use a sheath to cover the probe for each use (Am.Soc.Anes)
  3. Cover the nonessential machine surfaces with a disposable towel or sheet (Am.Soc.Anes)
  4. After use wipe down entire machine just outside of the room and be as thorough as possible. After appropriate wet time, wipe down the entire machine again. (Italian experience)
Undifferentiated Dyspnea/Fever/Critical Illness (ED)
  1. Wipe down the probe and cord with a proper disinfectant after each use (ACEP EUS/CUAP)
  2. Cover the nonessential machine surfaces with a disposable towel or sheet (Am.Soc.Anes)
  3. After use wipe down entire machine just outside of the room and be as thorough as possible. After appropriate wet time wipe down the entire machine again. (Italian experience)
Community Risk Patient (ED)-Where COVID-19 risk deemed equal to community risk
  1. Wipe down the probe and cord with a proper disinfectant after each use (ACEP EUS/CUAP)

Please be aware that the co-use of aerosolized therapy (nebulized medications and BiPAP) and POCUS with critically ill patients makes the machine an extra high risk to serve as a fomite. Please make sure to wipe down ALL surfaces in these situations.