Measures Taken by the Radiology Department

25 views 0 04/20/2020

 

1) Different types of patients in the radiology department

Patients should be separated based on risk of transmission :

  1. Suspected COVID-19 patient
  2. Confirmed COVID-19 patient
  3. Asymptomatic community patient

 

2) Postponement of elective procedures 

  1. Non-urgent procedures such as systematic evaluation of chronic diseases and screening procedures (e.g. mammography) should be postponed. 
  2. Management of general imaging emergencies should be maintained for in- and out-patients, including the evaluation of acute worsening of chronic disease. 
  3. 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:

  1. 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.
  2. Imaging department should dedicate a specific area (including waiting space) and specific equipment to the evaluation of these patients 
  3. 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. 
  4. 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. 
  5. 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 

  1. Interventional radiology presents a higher risk for infection transmission due to patient proximity.
  2. All procedures on confirmed COVID-19 cases should be undertaken in single-care isolation rooms.
  3. 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:

  1. A special report published in the Japanese Journal of Radiology on the 17 March 2020.
  2. 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. 
  3. A document from the European Society of Radiology (ESR) and the European Society of Thoracic Imaging (ESTI).
  4. A review article published in Diagnostic and Interventional Radiology, from Canada and Singapore.
  5. 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.

 

References:

  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
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