Table 1.

Summary of recommendation in Supplements of ASE statement

Pediatric, fetal, and congenital heart disease patients  Children less likely to be severely affected but may be asymptomatic carriers—screening strategies’ use for adults are likely to be less effective  When possible, keeping waiting and scanning areas for pregnant women/fetal echos separate from children is ideal  For low-risk patients with good cardiac imaging on routine anatomy scan, consider canceling fetal echo—specific recommendations for imaging of moderate- and high-risk patients discussed in detail in document  Consider telemedicine discussion of echo results for fetal echos—otherwise, consolidate visits as much as possible, i.e., combine with OB care  Given complexity of anatomy, focused TTE is likely superior to POCUS exams to limit need for repeating imaging  For intraoperative echo and all other TEE, all children without documented negative COVID testing within 72 h should be presumed positive  For intraoperative TEE, anesthesia should place probe immediately after intubation when full PPE is already being worn; probe should be removed while still under deep general anesthesia and cleaned immediately

Perioperative/periprocedural TEE  TEE carries a high risk for SARS-CoV-2 spread  TEE should be performed when clinical benefits outweigh the risks  Proper handling and cleaning of equipment are critical  Airborne precautions should be used in patients suspected or confirmed COVID-19

Sonographer  Sonographers need to be familiar with and prepared to implement strategies for reducing the risk of exposure to and transmission of the COVID-19 virus  Sonographers are encouraged to work with their medical teams to reschedule and/or defer all nonessential and nonemergent patients  Use of handheld devices by other trained providers may limit exposure to sonographers and conserve personal protective equipment (PPE)  In addition to the use of appropriate PPE, sonographers can use strategies that limit exposure while scanning and through appropriate cleaning of equipment

POCUS  POCUS can assist in the evaluation of suspected/confirmed COVID-19 infection  A cardiopulmonary POCUS protocol is provided, and implications discussed  A device-cleaning checklist is provided