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The following specific recommendations are made for the use of endocavitary ultrasound transducers. Users should
also review the documents from the Centers for Disease Control and Prevention on sterilisation and disinfection of
medical devices to be certain that their procedures conform to the CDC principles for
disinfection of patient care equipment.
1.
CLEANING
After removal of the probe cover, use running water to rinse off any residual gel or debris from the probe. Use a damp
gauze pad or other soft cloth and a small amount of mild liquid soap (household dishwashing liquid is ideal) to thor-
oughly cleanse the transducer. Consider the use of a small brush, especially for crevices and corners, depending on
the design of your particular transducer. Rinse the transducer thoroughly under running water, and then dry it with a
soft cloth or paper towel.
2.
DISINFECTION
Cleaning with a detergent/water solution as described above is extremely important as the first step in proper disinfec-
tion since chemical disinfectants act more rapidly on clean surfaces. However, the additional use of a highly effective
liquid disinfectant will ensure further statistical reduction of the microbial load. Due to potential permeability of the barri-
er sheath, additional high-grade disinfection with chemical agents is necessary. Examples of such high-grade disin-
fectants include but are not limited to:
2.4 – 3.2% glutaraldehyde products (a variant of the available proprietary products, including "Cidex",
"Metricide," or "Procide").
Non-glutaraldehyde agents, including Cidex OPA (ophthalaldehyde), Cidex PA (hydrogen peroxide & peroxyacetic
acid).
7.5% hydrogen peroxide solution.
Common household bleach (5.25% sodium hypochlorite) diluted to 500 parts per million of chlorine (10 cm³ in one litre
of tap water). This agent is effective, but generally not recommended by probe manufacturers because it can damage
metal and plastic parts.
Other agents such as quaternary ammonium compounds are not considered high-grade disinfectants and should not
be used. Isopropanol is not a high-grade disinfectant when used on a wiping cloth, and probe manufacturers generally
do not recommend soaking probes in the liquid.
The FDA has published a list of approved sterilants and high-grade disinfectants for use in processing reusable medi-
cal and dental devices. This list can be consulted to find agents that may be useful for probe disinfection.
Practitioners should consult the labels of proprietary products for specific instructions. They should also contact the
probe manufacturers with regard to the compatibility of these agents. Many of the chemical disinfectants are potentially
toxic and many require adequate precautions to be taken, such as proper ventilation, personal protective clothing
(gloves, face/eye protection, etc.) and thorough rinsing before reusing the probe.
3.
PROBE SHEATHS
The transducer must be covered by a barrier. If the barriers used are condoms, they must not be lubricated or medicat-
ed. Practitioners should be aware that condoms have been shown to be less prone to leakage than commercial probe
sheaths, and have a six-fold higher AQL (acceptable quality level) when compared to standard examination gloves. They
have an AQL equal to that of surgical gloves. Users should be aware of latex-sensitivity issues and have non-latex-
containing barriers available.