{"id":824,"date":"2020-06-04T11:41:42","date_gmt":"2020-06-04T06:11:42","guid":{"rendered":"http:\/\/www.potentialloops.org\/?p=824"},"modified":"2020-06-04T11:41:44","modified_gmt":"2020-06-04T06:11:44","slug":"interventional-radiologists-modify-protocol-for-coronavirus-disease-covid-19-pandemic","status":"publish","type":"post","link":"https:\/\/www.potentialloops.org\/?p=824","title":{"rendered":"Interventional radiologists modify protocol for coronavirus disease (COVID-19) pandemic"},"content":{"rendered":"\n

Date: June 3, 2020 <\/p>\n\n\n\n

Source 1: American Roentgen Ray Society<\/p>\n\n\n\n

Source 2: www.sciencedaily.com<\/a><\/p>\n\n\n\n

Summary: Radiologists who perform cross-sectional interventional procedures can take several steps to minimize the risks to patients and radiology personnel, including screening referred patients to decide which procedures can be postponed, using appropriate personal protective equipment (PPE), minimizing the number of people involved in procedures, preserving PPE when possible, and applying proper room and equipment cleaning measures. <\/p>\n\n\n\n

An open-access article in the American Journal of Roentgenology<\/em>\n (AJR) details myriad practical updates that radiologists performing \ncross-sectional interventional procedures should institute to minimize \nrisks for patients and imaging personnel alike during the coronavirus \ndisease (COVID-19) pandemic.<\/p>\n\n\n\n

“Cross-sectional interventional procedures are performed under CT, \nultrasound, fluoroscopy, or MRI guidance and include fluid aspiration, \n(thoracentesis, paracentesis, and fluid collections), drainage catheter \nplacement, percutaneous biopsy, and tumor ablation,” explained lead \nauthor Ghaneh Fananapazir at the University of California Davis Medical \nCenter.<\/p>\n\n\n\n

All of these procedures require appropriate donning and doffing of \npersonal protective equipment by every member of the IR team — \nphysician, trainee, nurse, technologist — and some procedures may \nrequire admitting the patient for management of postprocedure \ncomplications, necessitating a hospital bed and auxiliary resources.<\/p>\n\n\n\n

Thus, for procedural delays that will not adversely affect patient \noutcome, Fananapazir and colleagues proposed the following tiered \napproach for both outpatient and inpatient scenarios: urgent procedures,\n procedures that should be performed within 2 weeks, procedures that \nshould be performed within 2 months, and procedures that can safely be \ndelayed 2 or 6 months.<\/p>\n\n\n\n

“Each procedure request must be triaged into a tier on a case-by-case\n basis,” Fananapazir et al. warned, “because clinical circumstances can \ndictate one procedure as urgent, whereas different clinical data may \nrender the same procedure safe to delay.” When considering any \nprocedural delay, Fananapazir’s team strongly recommended consultation \nwith the referring physician, who may have insights not available to the\n interventional radiologist.<\/p>\n\n\n\n

Wherever possible, procedures should be performed bedside in COVID-19\n units (or patient rooms, should no dedicated COVID-19 unit exist). \nRegarding ultrasound-guided procedures, specifically, a mobile \nultrasound unit can be left in place in the ICU or the COVID-19 unit — \n“used for interventional procedures, guidance for vascular access, or \npoint-of-care thoracic and nonthoracic ultrasound,” wrote Fananapazir et\n al. Ultrasound probes should be sterilized according to manufacturer \nguidelines.<\/p>\n\n\n\n

Fananapazir’s team also cautioned against CT technologists or \nsonographers entering the procedure room. Ideally, all anticipated IT \ntray supplies should be acquired before the procedure commences, covered\n with a sterile plastic drape, and opened only to the extent needed.<\/p>\n\n\n\n

Additionally, patient interaction during the informed consent interview can be limited by obtaining consent in the procedure room or using documented oral consent in the medical record. “Both of these modifications to the consent process are outside of standard regulated practice,” the authors of this AJR article noted, “therefore, establishment of hospital-wide frameworks may be needed.”<\/p>\n\n\n\n

Story Source:<\/strong><\/p>\n\n\n\n

Materials<\/a> provided by American Roentgen Ray Society<\/strong><\/a>. Note: Content may be edited for style and length.<\/em><\/p>\n\n\n\n

www.sciencedaily.com<\/a><\/p>\n\n\n\n

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Journal Reference<\/strong>:<\/p>\n\n\n\n

  1. Ghaneh Fananapazir, Meghan G. Lubner, Mishal Mendiratta-Lala, \nBenjamin Wildman-Tobriner, Samuel J. Galgano, Ramit Lamba, J. Louis \nHinshaw, Olga R. Brook. Reorganizing Cross-Sectional Interventional Procedures Practice During the Coronavirus Disease (COVID-19) Pandemic<\/strong>. American Journal of Roentgenology<\/em>, 2020; 1 DOI: 10.2214\/AJR.20.23227<\/a>\n<\/li><\/ol>\n\n\n\n
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