Brigham and Women's Hospitals

Radiology Precautions

Radiology COVID-19 Precautions

In radiology suite

  1. COVID-19 Person Under Investigation (PUI) or Confirmed Case of COVID-19 needing to travel to Radiology Department
  1. Prior to patient arrival:
  1. Received notification regarding a COVID - 19 patient needing to travel to Radiology
  2. Coordinate time of exam with the unit
  3. Ensure designated room is left unoccupied and ready for patient arrival
  4. Designate staff who will be involved in the exam (minimum 2 for 1 clean and 1 dirty tech) and limit to as few staff as possible.
  5. Validate that staff who are assigned to work in the room have taken the Strict Precautions Donning and Doffing Training.
  6. Identify which tech is “dirty” and which tech is “clean”
  7. Remove all non-essential moveable equipment out of exam room
  8. Cover any immovable equipment that will not be used to care for the patient (i.e. power injector, etc.)
  9. Obtain precautions cart and ensure all required PPE is available outside of designated exam room
  10. Ensure PPE cart is stocked outside of room:
  11. Binder with checklists and forms
  12. Blue gowns
  13. Yellow gown with thumb loop
  14. Sign describing blue vs yellow gown use
  15. Extended and regular cuff gloves
  16. Face shields
  17. N-95 Respirators (small and regular sizes) – only needed for aerosol generating procedures
  18. Obtain “Strict Isolation Precautions room entry log” that should travel with the patient
  19. Ensure patient is wearing a surgical mask at all times during their stay in the Radiology exam room
  1. Upon exam completion and Patient Departure:
  1. Wipe down all equipment and surfaces in the room with appropriate cleaning wipes (while still wearing PPE)
  2. Allow room to sit for the required contact time, per cleaning wipes used
  3. Perform PPE DOFFING just inside the exam room at the door
  4. Ensure PPE is disposed of in the red biohazard waste bag.
  5. Page EVS to ensure all trash in the room is disposed of properly.
  6. Ensure PPE supplies are restocked, as needed:
  7. Binder with checklists and forms
  8. Blue gowns
  9. Yellow gown with thumb loop
  10. Sign describing blue vs yellow gown use
  11. Extended and regular cuff gloves
  12. Face shields
  13. N-95 Respirators (small and regular sizes)
  14. Complete the “Strick Isolation Precautions room entry log” sheet by adding all staff that interacted with the patient or were in the exam room
  15. Copy the log sheet and provide to area Assistant Clinical Director or Director for scanning to digital file (RADCHIEF > CORONAVIRUS > Occupational Health tracking sheets)
  16. Send original form back with patient

Ultrasound

  1. ICU Patient with Suspected or Confirmed COVID-19
  1. For rooms with an anteroom:
  1. Notify Ultrasound (x 27190) that an order has been placed for a patient on Strict Isolation precautions. All ultrasounds will be performed as portable, to limit patient travel.
  2. Remove all unnecessary probes from the Ultrasound machine (leave in clean area)
  3. Technologist will don PPE as per protocol
  4. Tech will then move the ultrasound machine into anteroom and close exterior door
  5. Once exterior door is closed, tech will open the patient room door and proceed into the patient room and the close the patient room door
  6. Tech will complete the imaging study. They may require assistance from the RN to assure optimal room set-up and patient positioning.
  7. Upon completion of the study, tech will move imaging device into anteroom and close patient room door
  8. The technologist will doff PPE with guidance from the doffing monitor
  9. Once PPE attire is disposed of properly, tech Purells hands and dons new gloves
  10. Tech then cleans all surfaces of imaging device with SaniWipes (and then waits 2 minutes)
  11. Tech removes gloves, Purells hand and puts on new gloves
  12. Tech removes ultrasound machine from anteroom, removes gloves in clean area, and Purells hands
  1. For rooms without an anteroom:
  1. Notify Ultrasound (x 27190) that an order has been placed for a patient on Strict Isolation precautions. All ultrasounds will be performed as portable, to limit patient travel.
  2. Remove all unnecessary probes from the Ultrasound machine (leave in clean area)
  3. Technologist will don PPE as per protocol
  4. Tech will then move the ultrasound machine into patient room and close room door
  5. Tech will complete the imaging study. They may require assistance from the RN to assure optimal room set-up and patient positioning.
  6. Upon completion of the study, tech will move imaging device to the room door
  7. While still in PPE, Tech then cleans all surfaces of imaging device with approved disinfectant
  8. Tech then opens the patient room door for PPE monitor to monitor doffing
  9. Tech doffs PPE except mask (i.e. remove gown/gloves/face-shield)
  10. Once PPE attire is disposed of properly, tech Purells hands and Dons new gloves.
  11. Tech then removes machine from room
  12. Tech removes gloves, Purells hand

X-Ray - Portable

  1. ICU Patient with Suspected or Confirmed COVID-19
  1. For rooms with an anteroom:
  1. Notify X-ray (Tower pager, #11870, Shapiro pager #12915, or CWN pager #11184) that an order has been placed for a patient on Strict Isolation precautions
  2. Place imaging cassette in clean plastic bag (while in the clean area)
  3. Remove all unnecessary aprons and material from the XRay machine
  4. Technologist will don PPE as per protocol
  5. Tech will then move imaging device into anteroom and close exterior door
  6. Once exterior door is closed, tech will open the patient room door and proceed into the patient room and the close the patient room door
  7. Tech will complete the imaging study. They may require assistance from the RN to assure optimal room set-up.
  8. Upon completion of the study, tech will move imaging device into anteroom and close patient room door
  9. Tech in the anteroom will begin to slide the plastic cover off the cassette taking care not to touch the cassette.
  10. A tech or RN in the clean area (and wearing gloves) will grasp the cassette and pull it out of the plastic bag. Care will be taken to not touch the plastic bag.
  11. The tech in the anteroom will dispose of the plastic bag in the anteroom trash container
  12. The technologist will doff PPE with guidance from the doffing monitor
  13. Once PPE attire is disposed of properly, tech Purells hands and Dons new gloves.
  14. Tech then cleans all surfaces of imaging device with SaniWipes (and then waits 2 minutes)
  15. Tech removes gloves, Purells hand and puts on new gloves
  16. Tech removes imaging machine from anteroom
  1. For rooms without an anteroom:
  1. Notify X-ray (Tower pager, #11870, Shapiro pager #12915, or CWN pager #11184) that an order has been placed for a patient on Strict Isolation precautions
  2. Place imaging cassette in clean plastic bag (while in the clean area)
  3. Remove all unnecessary aprons and material from the XRay machine
  4. Technologist will don PPE as per protocol
  5. Tech will then move imaging device into patient room and close exterior door
  6. Tech will complete the imaging study. They may require assistance from the RN to assure optimal room set-up.
  7. Upon completion of the study, tech will move imaging device to the room door
  8. Tech will open room door
  9. Tech will begin to slide the plastic cover off the cassette taking care not to touch the cassette.
  10. A tech or RN outside the patient room (and wearing gloves) will grasp the cassette and pull it out of the plastic bag. Care will be taken to not touch the plastic bag.
  11. The tech will close the room door
  12. The tech will dispose of the plastic bag in the trash container inside the patient room
  13. While still in PPE, Tech then cleans all surfaces of imaging device with approved disinfectant
  14. Tech then opens the patient room door for PPE monitor to monitor doffing
  15. Tech doffs PPE except mask (i.e. remove gown/gloves/face-shield)
  16. Once PPE attire is disposed of properly, tech Purells hands and Dons new gloves.
  17. Tech then removes machine from room
  18. Tech removes gloves, Purells hand