Ultrasound Infection Control: Student Guide and Review Quiz

Based on AIUM Guidelines (2025 Revision)

1. Cleaning:

- Definition: The physical removal of foreign material (gel, blood, dirt, debris) using water, soap, or enzymes.
- Why it matters: You cannot disinfect dirt. If gel or debris is left on the probe, it acts as a shield, preventing the disinfectant from reaching the surface. Disinfection will fail if cleaning is skipped.

2. Low-Level Disinfection (LLD):

- Definition: A chemical process that destroys most bacteria, some viruses, and some fungi.
- Note: LLD does not kill bacterial spores or Mycobacterium tuberculosis. It is generally effective against bloodborne pathogens like HIV and Hepatitis B.

3. High-Level Disinfection (HLD):

- Definition: A chemical process that destroys all microorganisms (bacteria, viruses, fungi, mycobacteria).
- Note: HLD t does not necessarily kill high numbers of bacterial spores (though it kills some).

4. Sterilization:

- Definition: The use of physical or chemical procedures to destroy all microbial life, including highly resistant bacterial spores.
- This is the highest possible standard of safety.

To know which level of cleaning/disinfection/sterilization to use, you must classify the device based on what it touches.

DISCONNECT: Unplug the transducer (if required by manufacturer/hospital policy).
CLEAN (The Pre-Step): Remove the cover. Use a soft cloth/wipe with mild soap to physically remove all bulk gel and visible soil. Do not skip this.
DISINFECT: Apply the chemical agent (LLD wipe or HLD soak).
- Critical Step for HLD: If using a soak, dry the probe first. Putting a wet probe into HLD fluid dilutes the chemical, making it ineffective.
RINSE: Thoroughly rinse with water to remove toxic chemical residue.
DRY & STORE: Dry with a clean cloth and hang/store to prevent recontamination.

Sterile Gel: MANDATORY for invasive procedures (biopsies) or scanning non-intact skin.
Single-Use Packets: Best for preventing cross-contamination between patients.
Multidose Bottles: Safe only for low-risk exams on intact skin. Never let the bottle tip touch the patient or the table.
Warming: Avoid heating gel unless medically necessary; warm gel promotes bacterial growth.

Manufacturer Guidelines: Always check if the specific chemical is approved for your specific probe. Using the wrong chemical can cause lens delamination (peeling rubber), which destroys image quality and harbors bacteria.
Inspect Daily: Check cables and housing for cracks. A cracked probe cannot be disinfected and is an electrical safety risk.

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