. 2015 Dec 31;18(3):96–99. doi: 10.1002/j.2205-0140.2015.tb00207.x

Table 1.

The Spaulding Classification applied to the disinfection of ultrasound probes.

Designation	Example Procedures	Level of Disinfection	Standards Recommendations for Ultrasound Probes
Critical Contacts sterile body cavity or tissue including the vasculature. ² ^, ³	Use of ultrasound probes in surgery; biopsies, punctures and drainages; vascular ablation; intraoperative procedures; venous catheter placement; transvaginal oocyte retrieval; needle guidance.	Sterilisation A sterilant is an agent that destroys all viable microorganisms. ¹ ^, ² ^, ⁴	Critical ultrasound probes should be sterilised between patients. If this is not possible, then the probe should undergo a minimum of HLD and be covered with a sterile probe cover. ⁶
Semi‐Critical Contacts intact nonsterile mucosa or non‐intact skin. ²⁵	Transvaginal, transrectal, transoesophageal ultrasound and any surface ultrasound procedure that involves broken skin such as wound scanning and burn graft evaluation.	High Level Disinfection (HLD) HLD kills all microorganisms except bacterial spores. ¹ HLD is the minimum requirement for reprocessing a semi‐critical device. ⁴ High level disinfectants must act as sterilants under prolonged exposure. ¹	Semi‐critical probes should be sterilised or minimally high level disinfected even if a sheath is used. ⁵ TGA approved HLDs referred to in the ASUM guidelines include glutaraldehyde, orfbo‐phthalaldehyde and hydrogen peroxide. ⁵ Intracavity probes should be used with a sheath.
Non‐Critical Contacts healthy intact skin. ²⁴	Surface ultrasound procedures that involve intact skin such as transabdominal pelvic ultrasound.	Low Level Disinfection (LLD) Low level disinfectants rapidly kill most vegetative bacteria and medium sized lipid containing viruses; not effective against bacterial endospores, mycobacteria, fungi, or all small non‐lipid viruses. ³ ^, ⁴	Non‐critical ultrasound probes should undergo cleaning and LLD. ² Low level disinfectants are also appropriate for environmental surfaces in the sonography clinic (e.g. probe cable, keyboard, and patient bed) however there are no specific standards on environmental disinfection for sonography.