The American Institute of Ultrasound in Medicine states that ultrasound providers must be safeguarded from COVID-19 transmission [1], [2], [3], [4]. Additionally, ultrasound examinations should be postponed to prioritize urgent procedures involving percutaneoushepato-biliary drainage and ablation of hepatocellular carcinoma. However, novel means for shielding against patient-generated aerosols remain undeveloped. A negative-pressure room should be prepared to turn off aerosol circulation when performing interventions for patients with COVID-19. However, such facilities are uncommon in ultrasonography units. We herein describe the use of a negative-pressure box under continuous suction for shielding against COVID-19 during ultrasound interventions (Fig. 1 A) (Video S1).
Fig. 1.
A. Overview image showing the shield for the patient during urgent abdominal ultrasound-guided interventions. The patient's upper body is almost completely shielded by the box. B. Prepared materials, consisting of a transparent vinyl bag (60 × 45 × 22 cm, 90 Liter capacity), kitchen rack (21 × 19 × 44 cm), and binder clips.
The prepared materials included a transparent vinyl bag, kitchen rack, and binder clips (Fig. 1B). Written informed consent was obtained. First, the box was created by clipping the bag inside the rack. Next, a suction tube was inserted into the openside of the box, resulting in a negative-pressure box. An oxygen-insufflated nasal tube was simultaneously inserted into the upper side of the box to maintain patient respiration (Fig. 2 A). After the right arm was raised outside the box via a suitable hole, the openside was wrapped with a clean disposable cloth on the mid-body. The upper body was almost completely shielded by the box (Fig. 2B).
Fig. 2.
A. Continuous aerosol suction is performed via a suction tube (white arrows) inserted into the open side of the box, resulting in negative pressure-box. B. An oxygen-insufflated nasal tube (green arrows) inserted into the upper side of the box helps to maintain patient respiration.
This method can be an alternative means for minimizing virus transmission during urgent abdominal ultrasound-guided interventions.
Conflict of interest
None declared.
Acknowledgments
Acknowledgment
We thank Angela Morben, DVM, ELS, from Edanz Group (https://en-author-services.edanzgroup.com/), for editing a draft of the manuscript.
Footnotes
Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.dld.2020.05.024.
Appendix. Supplementary materials
References
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