title: Efforts to Attenuate the Spread of Infection (EASI): a prospective, observational multicentre survey of ultrasound equipment in Australian emergency departments and intensive care units.
abstract: OBJECTIVE
  Ultrasound is a common and necessary part of acute care medicine, but may present an infection risk to patients secondary to transfer of infectious agents between patients. Our primary objective was to detect blood contamination on ultrasound equipment in emergency departments (EDs) and intensive care units. Secondary objectives included detection of microbial contamination and determination of factors associated with contamination.
  
  
  METHODS
  We tested ultrasound equipment used in five EDs and five ICUs for blood and microbial contamination, and collated and analysed contamination data using tables and multiple logistic regression.
  
  
  RESULTS
  We performed 109 tests for blood and 131 tests for microbial contamination, with 61% of samples testing positive for blood contamination (95% CI, 52%-71%) and 48% testing positive for microbiological contamination (95% CI, 40%-57%). Transducer leads and transducers had high blood contamination (88% and 57%, respectively) and microbiological contamination (62% and 46%, respectively). Equipment from ICUs was less likely to test positive (odds ratio, 0.55; 95% CI, 0.37-0.79). Only 51% of blood-contaminated samples were visibly stained, and visible staining was not associated with microbiological contamination (57%; P=1).
  
  
  CONCLUSIONS
  Our results show significant contamination of ultrasound equipment, and that visual inspection of equipment is neither sufficient nor reliable in excluding contamination. Ultrasound equipment is a possible factor in the transmission of infectious diseases in EDs and ICUs. Guidelines must be formulated, disseminated and rapidly adopted to ensure the safety of the most acutely ill patients exposed to ultrasound procedures in acute care settings.
authors.affiliation: Critical Care Research Group, University of Queensland, The Prince Charles Hospital, Brisbane, QLD, Australia. drmattkeys@me.com.
authors.forename: Matthew
authors.initials: M
authors.lastname: Keys
authors.affiliation: Critical Care Research Group, University of Queensland, The Prince Charles Hospital, Brisbane, QLD, Australia.
authors.forename: Beatrice Z
authors.initials: BZ
authors.lastname: Sim
authors.affiliation: Critical Care Research Group, University of Queensland, The Prince Charles Hospital, Brisbane, QLD, Australia.
authors.forename: Ogilvie
authors.initials: O
authors.lastname: Thom
authors.affiliation: Critical Care Research Group, University of Queensland, The Prince Charles Hospital, Brisbane, QLD, Australia.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Tunbridge
authors.affiliation: Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Adrian G
authors.initials: AG
authors.lastname: Barnett
authors.affiliation: Critical Care Research Group, University of Queensland, The Prince Charles Hospital, Brisbane, QLD, Australia.
authors.forename: John F
authors.initials: JF
authors.lastname: Fraser
mesh_terms: D001315:Australia; D001769:Blood; D004636:Emergency Service, Hospital; D004866:Equipment Contamination; D017053:Infection Control; D007362:Intensive Care Units; D011446:Prospective Studies; D014463:Ultrasonography / Q000295:instrumentation*