GEneral principles

  • Only consider POCUS if it has the potential to significantly alter care

  • Novices should not be using POCUS at this time

  • Stringent infection control precautions must be used

Indications for POCUS

  • Indications for POCUS in COVID-19

    • Procedural guidance (particularly thoracentesis and line insertion)

    • To evaluate for a possible alternative diagnosis (ie heart failure)

    • To monitor progression of severely ill patients, if the information will change management

    • To avoid the risks of transmission associated with radiology studies (CT, Echo)

  • Situations NOT to use POCUS

    • Educational scans

    • To assess progressive hypoxia in a patient with known COVID if no other diagnosis is suspected and it will not change management

    • As a diagnostic modality in patients who have already received a definitive test (RT-PCR)

POCUS machines and providers

  • POCUS providers

    • Novice users should not be performing scans on potential COVID patients

    • If possible, perform POCUS under the guidance of one of the POCUS faculty

    • Be sure to save all clips (4-6s) for faculty review and future clinical comparison

    • If there are questions about the role of POCUS in a COVID patient, please contact Dr Katie Wiskar (VGH) or Dr Barry Chan (SPH) from 0800-1700

  • POCUS machines

    • Scans should be done with dedicated COVID machines

    • SPH: COVID ward machine

    • VGH: Butterfly (new) - please contact Dr Katie Wiskar to obtain access to this machine

Infection Control Procedures

  • Do not bring any extra equipment (towels, gel bottles, etc) into the room

  • Use only single-use sterile gel packets

  • Do not use POCUS during aerosol-generating procedures

  • Work with your supervising POCUS faculty to ensure that you are following appropriate infection control procedures specific to your machine

    • Be clear on your protocol for cleaning/distinfecting the machine and how you are integrating this with donning/doffing before you scan

  • As appropriate, make use of sterile probe covers

  • Clean visibly soiled areas before disinfecting

  • Disinfect all machine surfaces with Caviwipes. Allow to dry completely before next use.

  • If an anteroom is available, machine disinfection should occur here. If not, machine should be cleaned and disinfected prior to exiting the patient room.