1) Different types of patients in the radiology department
Patients should be separated based on risk of transmission :
- Suspected COVID-19 patient
- Confirmed COVID-19 patient
- Asymptomatic community patient
2) Postponement of elective procedures
- Non-urgent procedures such as systematic evaluation of chronic diseases and screening procedures (e.g. mammography) should be postponed.
- Management of general imaging emergencies should be maintained for in- and out-patients, including the evaluation of acute worsening of chronic disease.
- Imaging activity related to the management of oncologic patients should be maintained.
3) Suggested protective measures for diagnostic radiology
If contact is necessary with a suspected or confirmed COVID-19 patient:
- The minimal personal protective equipment (PPE) for staff includes eye protection (goggles or face shield), a facemask, a filtering facepiece respirator (N95), a surgical cap, gloves, a fluid resistant gown, and shoe covers.
- Imaging department should dedicate a specific area (including waiting space) and specific equipment to the evaluation of these patients
- The use of a mobile CT unit close to the location where clinical triage is performed at the entrance to the hospital might be considered to limit transportation of patients.
- After leaving the CT suite, all contact surfaces (i.e. CT and MR machine gantries, operating consoles, blood pressure cuff, etc…) should be wiped with a cloth soaked with alcohol-based disinfectants after every contact.
- The CT suite should stay tightly closed for 1 h to thoroughly ventilate and exchange the room air.
If contact is necessary with an asymptomatic patient:
- The use of a standard medical mask is enough, unless aerosol-generating procedures are performed.
4) Suggested protective measures for interventional radiology
- Interventional radiology presents a higher risk for infection transmission due to patient proximity.
- All procedures on confirmed COVID-19 cases should be undertaken in single-care isolation rooms.
- For confirmed or suspected COVID-19 :
- Airborne infection isolation rooms (AIIR), respirators and facemasks are to be adopted
- All healthcare professionals in the room should wear an N95 or higher-level respirator, eye protection, gloves, and gownPPE is required
- The use of powered air purifying respirators (PAPR) is reserved for procedures that may involve cough or gas, increasing the risk of aerosolization
- The room should be promptly cleaned and disinfected after adequate time for air change has elapsed
This data was provided by:
- A special report published in the Japanese Journal of Radiology on the 17 March 2020.
- An article from the Radiology Scientific Expert Panel and Radiology Editorial Board describing their department’s top priorities for COVID-19 preparedness in their environment.
- A document from the European Society of Radiology (ESR) and the European Society of Thoracic Imaging (ESTI).
- A review article published in Diagnostic and Interventional Radiology, from Canada and Singapore.
- A review published in Journal of American College of Radiology, that discusses the precautions and safety measures for radiology department personnel to manage patients with known or suspected NCIP.
- Nakajima K, Kato H, Yamashiro T, Izumi T, Takeuchi I, Nakajima H, Utsunomiya D. COVID-19 pneumonia: infection control protocol inside computed tomography suites. Jpn J Radiol. 2020 Mar 17. doi: 10.1007/s11604-020-00948-y. Retrieved from https://link.springer.com/article/10.1007/s11604-020-00948-y
- Mossa-Basha, Mahmud, et al. “Radiology Department Preparedness for COVID-19: Radiology Scientific Expert Panel.” Radiology, Mar 16 2020 doi: 10.1148/radiol.2020200988. Retrieved from: https://pubs.rsna.org/doi/full/10.1148/radiol.2020200988
- Marie-Pierre Revel, Anagha P. Parkar, Helmut Prosch, Mario Silva, Nicola Sverzellati, Fergus Gleeson, Adrian Brady. COVID-19 patients and the Radiology department – advice from the European Society of Radiology (ESR) and the European Society of Thoracic Imaging (ESTI). Eur Society of Radiol. 2020 Apr 02. Retrieved from : https://www.myesr.org/sites/default/files/2020-04/COVID%20and%20Radiology%20departments_Website%20version%20April%202-2.pdf
- Chandy PE, Nasir MU, Srinivasan S, Klass D, Nicolaou S, Babu SB. Interventional radiology and COVID-19: evidence-based measures to limit transmission. Diagn Interv Radiol. 2020 Mar 31. doi: 10.5152/dir.2020.20166. Retrieved from : https://www.dirjournal.org/en/interventional-radiology-and-covid-19-evidence-based-measures-to-limit-transmission-132206
- Kooraki S, Hosseiny M, Myers L, Gholamrezanezhad A. Coronavirus (COVID-19) Outbreak: What the Department of Radiology Should Know. J Am Coll Radiol. 2020 Apr;17(4):447-451. doi: 10.1016/j.jacr.2020.02.008. Epub 2020 Feb 19