ACEP Safety Subcommittee Article: Common POCUS-safety Problems and Solutions

Problem

Solution

Cleaning wipe issues: Nonmanufacturer approved wipes, low level disinfection wipes vs. intermediate level, no cleaning performed at all

• Attach the correct wipes directly to the machine
• Post signage showing the approved wipe type
• Stock only intermediate-level disinfection wipes
• Add wipe restocking to the tech shift checklist

Nonsterile gel for percutaneous procedures, like IV starts

• Stock only sterile single-use gel packets
• Store sterile gel near long IV catheters and probe covers
• Create prepackaged ultrasound IV kits including sterile gel

Noncompliance with probe covers for IV starts

• Include probe covers in ultrasound IV kits
• Stock probe covers on the machine
• Standardize staff training to reinforce routine probe cover use

Expired gel remains in use

• Use smaller gel bottle sizes
• Date bottles in clean storage before use
• Schedule a specific date to refresh gel bottles every 3 to 4 weeks
• Switch to single-use gel packets

Probes cords damaged by cart wheels

• Protect cords with spiral cable wrap
• Attach pulleys, like scuba dive retractors or ones designed for virtual reality equipment, to keep cables off the floor

Hospital accreditation organization prohibits storage of sharps on the ultrasound cart 

• Store long IV catheters in a locked box on the cart or in locked room carts
• Park machines outside of patient care areas
• Store long IV catheters at the physician work station

Probes are contaminated with blood during trauma activations

• Pre-cover probes after EMS notification
• Replace probe covers after each trauma activation