Probe Care

Probe disinfection is critical in protecting patient and hospital staff:

1. There are risks associated with not doing proper probe reprocessing. For example, up to 7% of ultrasound probes were found to be contaminated with human papillomavirus (HPV) after disinfection with low level wipes.^1,2,3
2. Spaulding Classification is a widely used framework that specifies medical device reprocessing requirements based on the intended use.

1. The probe disinfection landscape in Europe is changing. A 2016 European Society of Radiology (ESR) study found a wide range of practices across Europe, with a need to raise awareness among practitioners of the importance of infection prevention and control measures.

Based on that, the ESR issued a best practice recommendation in November 2017:

• High level disinfection of probes is mandatory for endocavitary ultrasound and all interventions.
• Automated systems offer standardized and reproducible decontamination processes, helping to avoid operator-associated errors or variations.
• Dedicated transducer covers should be used for endocavitary ultrasound and all interventions.
• Sterile gel should be used for endocavitary ultrasound and all interventions.

Some countries have already started to develop their own regulations further:

• In 2017, Ireland and Scotland made high level disinfection mandatory between examinations.⁴
• In 2019 the French Ministry of Health published data sheets about endocavity probe reprocessing for healthcare professionals.⁵
• Other countries recommend strongly the same practices.⁶

1. Casalegno JS, Le Bail Carval K, Eibach D, Valdeyron ML, Lamblin G, Jacquemoud H, et al. High risk HPV contamination of endocavity vaginal ultrasound probes: an underestimated route of nosocomial infection? PloS one. 2012;7(10):e48137
2. Ma ST, Yeung AC, Chan PK, Graham CA. Transvaginal ultrasound probe contamination by the human papillomavirus in the emergency department. Emergency medicine journal. 2013;30(6):472–5
3. M’Zali F, Bounizra C, Leroy S, Mekki Y, Quentin-Noury C, Kann M. Persistence of Microbial Contamination on Transvaginal Ultrasound Probes despite Low-Level Disinfection Procedure. PloS one. 2014;9(4):e93368.
4. https://hpspubsrepo.blob.core.windows.net/hps-website/nss/1937/documents/1_RES-183-1-v1.pdf (IIrish HSE Guidance for Decontamination of Semi‐critical Ultrasound Probes QPSD-GL-028-1- 2017) Health Service Executive (HSE) Quality Improvement Division (2017). HSE Guidance for Decontamination of Semi‐critical Ultrasound Probes; Semi‐invasive and Non‐invasive Ultrasound Probes. Document: QPSD-GL-028-1
5. https://solidarites-sante.gouv.fr/soins-et-maladies/qualite-des-soins-et-pratiques/securite/article/prevention-des-risques-d-infection-associes-a-l-utilisation-des-sondes-d
6. Werkgroep Infectie Preventie (2017). Reiniging, desinfectie en sterilisatie van medische hulpmiddelen voor hergebruik niet-kritisch, semi-kritisch of kritisch gebruik: 56.
   Direzione Sanitaria AUSL Pescara (2009). Linee Guida per la “Corretta gestione di Procedure Assistenziali e Igienico-Sanitarie in Setting di Cura Ospedalieri e Territoriali”: 88.
   Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO), and Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM), (2012). Anforderungen an die Hygiene bei der Aufbereitung von Medizinprodukten. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz: 66.
   Society and College of Radiographers and British Medical Ultrasound Society (2017). «Guidelines For Professional Ultrasound Practice.» 127.
   Welsh Health Technical Memorandum (WHTM) (2014). WHTM 01-06 - Decontamination of flexible endoscopes Part C: Operational management, NHS Wales Shared Services Partnership – Specialist Estates Services: 74

Ultrasound probe disinfection can be done in several ways:

Please check the probe manufacturer’s specifications to ensure the probe and disinfectant are compatible: www.gehealthcare.com/transducers

Learn more about probe disinfection in our e-book.

GE Healthcare recommends in its user manual the following about cleaning and disinfection of ultrasound probes.

“Adequate cleaning and disinfection between patient cases are necessary to prevent disease transmission. All probes must be thoroughly cleaned prior to disinfection. The level of disinfection required is based on patient contact.”

• Probes that contact mucosal or non-intact skin require cleaning followed by high-level disinfection by either soaking or use of an automated system such as trophon®2 or TD100®.
• Probes that contact intact skin require cleaning followed by intermediate-level disinfection (wipe or spray).

At GE Healthcare, we offer you the trophon®2**, an automated high-level disinfection system for standard and endocavitary ultrasound probes. It allows a standardized and reproducible process.

Automated and compact

• Easy to use
• 7 minutes cycle, the time required for trophon®2 to eliminate all microorganisms
• Fits into the examination room by its small dimensions

Probe compatibility

• Validated by ultrasound manufacturers¹
• Compatible with more than 1000 models of standard, endocavitary and intraoperative probes

Helps to protect patients, staff and environment²

• Patients, reducing the risk of cross contaminations during ultrasound exams
• The staff and the environment by decomposing the disinfectant into water and oxygen, avoiding any exposure to the chemical

Effective on micro-organisms

• The efficiency and superiority³ of the hydrogen peroxide vaporization technique*** of trophon®2 have been demonstrated on microorganisms such as papillomavirus⁴
• The trophon®2 avoids contamination by pathogens: HIV, hepatitis B and C and chlamydia⁵

Traceability solution

• AcuTrace™ simplifies the creation and preservation of accurate and auditable digital records
• Acutrace™ PLUS makes it possible to integrate the trophon®2 into the Hospital Information System and into the Electronic Medical Record of the patient⁶

^{** Not available in all countries, please contact us to know more
*** in comparison with other disinfection techniques}

1. https://www.nanosonics.us/trophon/probe-compatibility/
2. https://www.nanosonics.us/trophon/safe-versatile-simple/
3. Nyhsen CM, Humphreys H, Koerner RJ, Grenier N, Brady A, Sidhu P, et al. Infection prevention and control in ultrasound - best practice recommendations from the European Society of Radiology Ultrasound Working Group. Insights into imaging. 2017.
4. C. Meyers, Inactivation des papillomavirus humains au niveau des sondes échographiques: synthèse des travaux récents. Hygiènes, Volume XXIV n° 4 – 2016
5. https://www.nanosonics.co.uk/clinical/microbial-efficacy/
6. https://www.nanosonics.co.uk/trophon2-traceability-and-it-integration/