Sonographer safety issues during the COVID-19 pandemic
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LETTER TO THE EDITOR
Sonographer safety issues during the COVID‑19 pandemic Nikki Brewer1 · Gary Huang1 · Younghoon Kwon1 Received: 1 May 2020 / Accepted: 11 May 2020 © Japanese Society of Echocardiography 2020
Dear Editor, We have read with great interest the article by Marriner et al., which provided important insights from a sonographer’s standpoint into the processes of ensuring high-quality echocardiography [1]. An emerging area of concern for sonographers or echocardiographers is the issue of safety, especially in the setting of the COVID-19 pandemic, given the imminent danger the pandemic has placed on front-line healthcare workers [2, 3]. A recent report by the CDC suggested that healthcare workers account for about approximately 11% of COVID-19 infections, but this number is likely underestimated due to the lack of testing and reporting [4]. As asserted by Marriner et al., the highly specialized knowledge and skills of sonographers is crucial in the diagnosis and treatment of patients [1]. Such skillsets are particularly vital during the COVID-19 pandemic, given the noninvasive, convenient, and portable nature of echocardiography. While overall echocardiography volume has decreased, driven by health system-wide mandates to control the pandemic, the need for timely performance of high-quality echocardiography, particularly for critically ill patients when indicated, remains great. Sonographers are at an especially high risk of exposure in the setting of this pandemic due to our close proximity to the patient during the scan, with the study duration ranging from 20 min to upwards of 1 h [3]. As Seattle, Washington became the initial epicenter of COVID-19, sonographers in the region experienced firsthand the challenges associated with maintaining safety This comment refers to the article available at https://doi. org/10.1007/s12574-019-00430-3. * Gary Huang [email protected] 1
Division of Cardiology, Department of Medicine, Harborview Medical Center, University of Washington, 325 9th Avenue, Box 359748, Seattle, WA 98104, USA
amidst the pandemic [5]. As the outbreak ensued, our echocardiography laboratory developed, after having undergone many revisions, safety measures in line with hospital policies and state public health recommendations. Areas in which these changes occurred included personal protective equipment (PPE) usage, COVID-19 testing criteria, and examination protocols. The major challenges facing our sonographers have been a shortage in the supply of PPE and ambiguous testing criteria for staff. PPE, including N95 masks and powered air purifying respirators (PAPR) hoods, are strictly worn by sonographers performing transthoracic or transesophageal echocardiography (TEE) in patients with suspected or confirmed COVID-19 infection. TEE performed on confirmed negative COVID-19 patients still required droplet precaution, including wearing surgical masks and eye protection. As recently announced by the Society of Diagnostic Medical Sonography in an open letter, we believe an adequate supply o
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