A transvaginal ultrasound exam is a common procedure performed thousands of times every day in the United States. A TVUS (transvaginal ultrasound) may be required for many applications such as pregnancy monitoring, fertility treatment, routine screenings or diagnosis. Today we’ll review five tips to keep your endovaginal exams safe and comfortable for your patients. We will be talking about regular scans that do not involve invasive acts (invasive acts: biopsies, aspirations or treatment deliveries)

Ultrasound grows in popularity from year to year, mainly due to its low-cost of acquisition and operation (compared to other imaging modalities), its ease of use, and its absence of danger for both patients and professionals.

Even if ultrasounds don’t expose the patient to ionizing radiation, they are not exempt of danger. Spread of infections and cross-contamination (contamination of the transducer by the patient and vice versa) are the most critical risks encountered when performing an endovaginal ultrasound exam. According to CDC, Healthcare Associated Infection (aka Hospital Acquired Infection – HAI) account each year for $35 to $45 billion in extra cost to our healthcare system.

Fortunately, there are ways to reduce the risks associated with transvaginal or transrectal ultrasound. Let’s jump right into it.

Tip #1: Use an appropriate ultrasound cover

As obvious as it seems, the probe cover is not an option here. And by probe cover, we mean products designed and labeled as so, no cut gloves or other DIY fancy solutions! You can use condoms, but they must be non-lubricated and non-medicated (lubricants and other coatings can carry infectious agents).

Tip #2: Wear gloves

Now that your patient and your transducer are protected, let’s talk about you. You should be wearing gloves throughout all the procedure, from the moment you cover your probe to the moment you take it off. No need for sterile gloves though. However, you may also want to use latex-free gloves, for the same reasons as explained above. The gloves will keep your hands from body fluids, and will also protect the handle of the transducer.

At the end of the endocavity ultrasound exam, be sure to remove the probe cover before taking off your gloves. Pay attention not to contaminate the transducer with the soiled gloves or with the cover. Dispose of them immediately, following your facility’s guidelines. Finally, never reuse, wash or re-sterilize your gloves.

Tip #3: Use sterile ultrasound gel

When it comes to ultrasound gel, the ESR survey points out that 35% of practitioners use refill bottles for a transvaginal ultrasound exam. While using a refill bottle is no big deal, these are more likely to host microorganisms compared to single use containers. If you use refill bottles, make sure to change your bottle on a regular basis, and to discard gel that may have been in contact with air for too long.

Tip #4: Clean & Disinfect your probe between each patient

As mentioned above, your endocavity transducer is a Semi-Critical device. That being, it must be cleaned, and then High-level disinfected between each patient.

According to the ESR, 11% of the responders would clean or disinfect their probe at the end of the patient list only! Another 69% of the practitioners would only clean the probe with a soft tissue, and perform a low-level disinfection with a wipe or foam. Finally, only 18% of the physicians carry-out a proper high-level of disinfection after each patient.

Tip #5: Store your transducer properly between each ultrasound exam

The final step for keeping a probe clean and free from microorganisms is to store it appropriately. Right after the disinfection cycle, you must store your transducer in a way to avoid recontamination. Hence, The Joint Commission (aka JCAHO or TJC) has issued guidelines for when your device is not in use: “Store the device in a manner that will protect from damage or contamination and that is consistent with national guidelines and manufacturers’ recommendations such as hanging vertically in a cabinet and storing in a clean environment”