News | Coronavirus (COVID-19) | June 05, 2020

Interventional Radiologists Modify Protocol for Coronavirus Disease

Chief among the myriad practical updates to minimize risks for patients and imaging personnel alike is a tiered approach for delaying both outpatient and inpatient cross-sectional interventional procedures

Chief among the myriad practical updates to minimize risks for patients and imaging personnel alike is a tiered approach for delaying both outpatient and inpatient cross-sectional interventional procedures

For procedural delays that will not adversely affect patient outcome, Fananapazir and colleagues proposed the following tiered approach for both outpatient and inpatient scenarios: urgent procedures, procedures that should be performed within 2 weeks, procedures that should be performed within 2 months, and procedures that can safely be delayed 2 or 6 months. Courtesy of American Journal of Roentgenology (AJR)

All cross-sectional interventional procedures require appropriate donning and doffing of personal protective equipment by every member of the IR team--physician, trainee, nurse, and technologist.

All cross-sectional interventional procedures require appropriate donning and doffing of personal protective equipment by every member of the IR team--physician, trainee, nurse, and technologist. Courtesy of American Journal of Roentgenology (AJR)

June 5, 2020 — An open-access article in the American Journal of Roentgenology (AJR) details myriad practical updates that radiologists performing cross-sectional interventional procedures should institute to minimize risks for patients and imaging personnel alike during the coronavirus disease (COVID-19) pandemic.

"Cross-sectional interventional procedures are performed under CT, ultrasound, fluoroscopy, or MRI guidance and include fluid aspiration, (thoracentesis, paracentesis, and fluid collections), drainage catheter placement, percutaneous biopsy, and tumor ablation," explained lead author Ghaneh Fananapazir at the University of California Davis Medical Center.

All of these procedures require appropriate donning and doffing of personal protective equipment by every member of the IR team — physician, trainee, nurse, technologist — and some procedures may require admitting the patient for management of postprocedure complications, necessitating a hospital bed and auxiliary resources.

Thus, for procedural delays that will not adversely affect patient outcome, Fananapazir and colleagues proposed the following tiered approach for both outpatient and inpatient scenarios: urgent procedures, procedures that should be performed within 2 weeks, procedures that should be performed within 2 months, and procedures that can safely be delayed 2 or 6 months.

"Each procedure request must be triaged into a tier on a case-by-case basis," Fananapazir et al. warned, "because clinical circumstances can dictate one procedure as urgent, whereas different clinical data may render the same procedure safe to delay." When considering any procedural delay, Fananapazir's team strongly recommended consultation with the referring physician, who may have insights not available to the interventional radiologist.

Wherever possible, procedures should be performed bedside in COVID-19 units (or patient rooms, should no dedicated COVID-19 unit exist). Regarding ultrasound-guided procedures, specifically, a mobile ultrasound unit can be left in place in the ICU or the COVID-19 unit — "used for interventional procedures, guidance for vascular access, or point-of-care thoracic and nonthoracic ultrasound," wrote Fananapazir et al. Ultrasound probes should be sterilized according to manufacturer guidelines.

Fananapazir's team also cautioned against computed tomography (CT) technologists or sonographers entering the procedure room. Ideally, all anticipated IT tray supplies should be acquired before the procedure commences, covered with a sterile plastic drape, and opened only to the extent needed.

Additionally, patient interaction during the informed consent interview can be limited by obtaining consent in the procedure room or using documented oral consent in the medical record. "Both of these modifications to the consent process are outside of standard regulated practice," the authors of this AJR article noted, "therefore, establishment of hospital-wide frameworks may be needed."

For more information: www.arrs.org

Related Coronavirus Content:

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS)

The Cardiac Implications of Novel Coronavirus

CT Provides Best Diagnosis for Novel Coronavirus (COVID-19)

Radiology Lessons for Coronavirus From the SARS and MERS Epidemics

Deployment of Health IT in China’s Fight Against the COVID-19 Epidemic

Emerging Technologies Proving Value in Chinese Coronavirus Fight

Radiologists Describe Coronavirus CT Imaging Features

Coronavirus Update from the FDA

CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia

CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV)

Chest CT Findings of Patients Infected With Novel Coronavirus 2019-nCoV Pneumonia 

Find more related clinical content Coronavirus (COVID-19)

ACC COVID-19 recommendations for the cardiovascular care team

VIDEO: What Cardiologists Need to Know about COVID-19 — Interview with Thomas Maddox, M.D.

The Cardiac Implications of Novel Coronavirus

ESC Council on Hypertension Says ACE-I and ARBs Do Not Increase COVID-19 Mortality

Related Content

MRI of Nonferromagnetic Ballistics Suspended in Gelatin. 

MRI of Nonferromagnetic Ballistics Suspended in Gelatin. Scout (A), T1-weighted spin-echo (SE) (B), T2-weighted SE (C), T2-weighted gradient-recalled echo (GRE) (TR/TE, 500/10; D), and T2-weighted GRE (TR/TE, 700/30; E) MR images show jacket hollow point .45 automatic Colt pistol bullet (Corbon) (1), solid lead .45 Long Colt bullet (Winchester) (2), full metal jacket (FMJ) automatic Colt pistol bullet (Winchester) (3), 5.56-mm FMJ bullet (Federal Ammunition) (4), #7 lead shotgun pellet (Winchester) (5), and 5-mm lead air gun pellet (Sheridan) (6). On all sequences, metallic artifact is minimal. Although metallic artifact increases or blooms with increased TR/TE in GRE images (D and E), amount of surrounding distortion is still minimal.

News | Magnetic Resonance Imaging (MRI) | January 15, 2021
January 15, 2021 — 
Novel Coronavirus SARS-CoV-2 Transmission electron micrograph of SARS-CoV-2 virus particles, isolated from a patient. Image captured and color-enhanced at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. Credit: National Institute of Allergy and Infectious Diseases, NIH

Novel Coronavirus SARS-CoV-2 Transmission electron micrograph of SARS-CoV-2 virus particles, isolated from a patient. Image captured and color-enhanced at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. Image courtesy of  National Institute of Allergy and Infectious Diseases (NIH)

News | Coronavirus (COVID-19) | January 15, 2021
January 15, 2021 — In one of the first studies to examine the impact of the...
Myocarditis among recovering COVID-19 athletes less common than previously reported

Getty Images

News | Cardiac Imaging | January 11, 2021
January 11, 2021 — In a letter published in the December issue of the American Heart Association's...
The FDA is monitoring the potential impact of viral mutations, including an emerging variant from the United Kingdom known as the B.1.1.7 variant, on authorized SARS-CoV-2 molecular tests

Getty Images

News | Coronavirus (COVID-19) | January 08, 2021
January 8, 2021 — The U.S.
In this roundtable discussion hosted by ITN Editorial Director Melinda Taschetta-Millane, three medical experts will discuss the impact COVID-19 had on the industry in 2020, as well as projections for the industry in 2021.
Webinar | Coronavirus (COVID-19) | January 06, 2021
2020 was an unprecedented year, as the world grappled with a...
Who should get the COVID vaccine? Roberto Lang, M.D., director of noninvasive cardiac imaging, University of Chicago Medical Center and former American Society of Echocardiography (ASE) president, received his first dose of the COVID vaccine in December. In addition to front line hospital workers, nursing home staff and residents also qualified for the first round of vaccinations. Right, Shannon Yaw, a nurse at a hard-hit nursing home in Michigan, received her first dose just before Christmas.

Roberto Lang, M.D., director of noninvasive cardiac imaging, University of Chicago Medical Center and former American Society of Echocardiography (ASE) president, received his first dose of the COVID vaccine in December. In addition to front line hospital workers, nursing home staff and residents also qualified for the first round of vaccinations. Right, Shannon Yaw, OTR/L, director of rehabilitation at a hard-hit nursing home in Michigan, received her first dose just before Christmas. nurse at a hard-hit nursing home in Michigan, received her first dose just before Christmas.

News | Coronavirus (COVID-19) | January 04, 2021
The Centers for Disease Control and Prevention (CDC) Dec.
#coronavirus #COVID19 #pandemic

Getty Images

News | Radiology Imaging | January 01, 2021
The Imaging Technology News (ITN) team wishes you a Happy and Healthy New Year!
After “COVID-19,” the term that most people will remember best from 2020 is likely to be “social distancing.” While it most commonly applied to social gatherings with family and friends, it has impacted the way many receive medical care. Historically, the United States has been relatively slow to broadly adopt telemedicine, largely emphasizing in-person visits.

Getty Images

News | Teleradiology | December 31, 2020
December 31, 2020 — After “COVID-19,” the term t
Volpara Health announced two new research studies using AI-powered software to score breast density objectively and consistently to evaluate its impact in mammography and breast cancer risk assessment.
News | Breast Density | December 30, 2020
December 30, 2020 — Volpara Health announced two new research studies using...