Aseptic handling of ultrasound probe: An easy solution

Sir, Ultrasonography (USG) is nowadays routinely used in anesthesia and critical care practice for nerve blocks, central venous cannulation, and tapping of pleural or pericardial effusions. There have been reports of bacterial infections transmitted through ultrasound probe and coupling gel.[1] To prevent or minimize the risk of infection, USG probe and its cable are generally wrapped in commercially available sterile disposable sleeve. In case of its nonavailability surgical drape, autoclavable sleeves, surgical gloves, or condoms are used. Of these, gloves are the ones majority of USG users are familiar with. The technique includes wearing two pairs of gloves one above another, holding the USG probe having jelly applied over transducer surface with one hand, followed by removing the outer glove inside out over the probe. However, the technique requires multiple maneuvers to fasten the fingers of the glove just above the probe. In addition, some amount of air is invariably left within the glove which affects image quality. In a modified technique to avoid fastening manures, a finger portion of glove is removed aseptically, and the probe with applied coupling gel is advanced through it to cover the probe.[2] Although “sterile glove” technique allows the probe to be used in aseptic condition, the uncovered accompanying cable always carries the risk of contaminating the procedural area during manipulations with the probe.