ESR best practice recommendations for infection prevention and control in ultrasound (US)

European Society of Radiology Ultrasound Working Group have released best practice recommendations for infection prevention and control in ultrasound with an aim to highlight the importance of infection prevention and control in ultrasound (US), including diagnostic and interventional settings.The recommendations were prepared after a review of available publications and discussion within a multidisciplinary group consistent of radiologists and microbiologists, in consultation with European patient and industry representatives.

Good basic hygiene standards are essential. All US equipment must be approved prior to first use, including hand held devices. Any equipment in direct patient contact must be cleaned and disinfected prior to first use and after every examination. Regular deep cleaning of the entire US machine and environment should be undertaken. Faulty transducers should not be used. As outlined in presented flowcharts, low-level disinfection is sufficient for standard US on intact skin. For all other minor and major interventional procedures as well as all endo-cavity US, high level disinfection is mandatory. Dedicated transducer covers must be used when transducers are in contact with mucous membranes or body fluids and sterile gel should be used inside and outside covers.

Major Recommendations

• Good standards of basic hygiene and thorough decontamination of all US equipment, as well as appropriate use of US gel and transducer covers, are essential to keep patients safe.


• Transducers must be cleaned/disinfected before first use and after every examination.


• Low level disinfection is sufficient for standard US on intact skin. High level disinfection is mandatory for endo-cavity US and all interventions.


• Dedicated transducer covers must be used for endo-cavity US and all interventions.


• Sterile gel should be used for all endo-cavity US and all interventions.