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Report helps radiology departments prepare for Ebola

by Lisa Chamoff, Contributing Reporter | November 20, 2014
Infection Control
Dr. David Bluemke
In a new report in the online edition of the journal Radiology, radiologists from the National Institutes of Health (NIH) and Emory University School of Medicine provide advice on how to prepare for imaging patients with the Ebola virus.

As hospitals throughout the U.S. conduct Ebola preparedness training, "radiology should be on the table for those discussions," Dr. David Bluemke, director of the Department of Radiology and Imaging Sciences at the NIH Clinical Center and the report's co-author, told DOTmed News.

Imaging is likely to be required when patients are first assessed in the emergency department, to exclude other diagnoses, and then later in an isolation unit to assess complications of the virus, such as a pulmonary infiltrate, and for line placement.

The NIH Clinical Center in Bethesda, Md., and Emory University Hospital in Atlanta are two of the four U.S. biocontainment facilities with specialized isolation rooms and staff trained to treat patients with Ebola virus. Bluemke said that other hospitals, particularly in major cities that see travelers from West Africa, are also setting up isolation units.

The report notes that every effort should be made to perform X-ray exams in the isolation room, rather than transporting the patient to the radiology department, which would require many precautions, including coordinating the patient transportation route with the hospital's infection control team. It also takes several hours to fully disinfect radiology exam rooms, which may prohibit treatment of other hospital patients.

Radiology departments need to develop standard operating procedures for performing imaging procedures in an isolation unit, and the report outlines two different strategies. With the first strategy, the radiologic technologists do not enter the patient's room, but instead stay in the anteroom and provide verbal instructions to nurses or doctors working directly with the patient on how to use equipment. In the second approach, the technologists enter the patient's room to assist other health care workers in operation of the imaging equipment, which is needed when the equipment is somewhat more complex.

Emory University Hospital took the former approach, with the technologist staying in the anteroom and instructing the health care worker on how to position the detector, which is double bagged.

"The thought has always been, for the most part, to ensure that the fewest number of health care workers are in the patient's room," report co-author Dr. Carolyn Meltzer, chair of the radiology department at Emory University School of Medicine, told DOTmed News.

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