As the Coronavirus unfolds in front of all of us, we are constantly reevaluating our workflows.
One of the common questions coming up in imaging departments across the country is how to conduct workflow in our CT scanners for Covid-19 patients.
The main concern, of course is how to keep both hard working staff and patients safe.
First and foremost, know how to properly don your PPE.
Clean Tech and Dirty Tech
With this method, one technologist stays “clean” and needs no PPE. The second technologists utilizes PPE because they will be in the “dirty” environment.
There is a basic representation of this method on YouTube for General Xray.
One common method for scanning patients is a workflow that uses two people. Commonly it is two technologists but it can work with other healthcare workers.
If your hospital is short on staff, whether it is from sick calls or voluntary quaranine due to travel policies, you can use other ancillary staff.
Medical Assistants, Certified Nursing Assistants, and just about any other healthcare worker can assist in scanning by placing patients on the table.
Optimally, two technologists will ensure that an optimal and diagnostic image will be acquired.
This workflow process can be used in any modality including MRI and General Xray.
Here’s How it Works
In a best-case scenario, the Clean Tech stays in the control room. This keeps one person out of harms way and reduces the use of valuable PPE.
The Clean Tech can fully communicate with everyone in the scan room via the console microphone.
The clean Tech doesn’t leave the control room.
The Dirty Tech does patient care and positioning.
The Dirty Tech transports the patient into the scan room and transfers them to the scan table.
Therefore, It will stand as far to the corner as possible and wear protective lead if necessary to protect against scatter.
This part depends on how much room you have in your scan room. The Dirty Tech needs to take every precaution available to minimize radiation exposure.
Then return the patient to the gurney and transport back to their unit when the scan is complete.
In some cases, the ED nurses (already “dirty”) are transporting patients to CT and back. Simple instructions from the Clean Tech advise the nurse how to position the patient.
CT Room Disinfect Protocol
Before any suspected Covid patients are scanned, all non-essential items are removed from the scan room.
Moreover, Items like injector syringes, glove boxes, Sani-Cloth bottles, linens, etc. They all get relocated to the Control Room.
Environmental Services is contacted prior to the scan and alerted. Once the scan is completed, they are called again and arrive to wipe down the room.
Each Environmental Services department will have their own protocol.
Our facility has a Dirty and Clean team member for disinfecting in much the same way we utilize technologists.
Moreover, One stays outside the scan room and one is inside the scan room. They hand off cleaning instruments to each other for bagging.
The entire room, including walls up to the ceiling, are wiped with Covid-approved cleaning solutions (noted in this article).
If someone other than Environmental Services is utilized (like Technologists), the same protocol is still followed. Anyone cleaning must be fully gowned and PPE’d.
Wait Time Post Disinfection of Room
It is suggested that a one-hour downtime is best to allow for air handlers to remove the airborne particles.
Some air handlers can get this done in 30 minutes. Your Building Engineers should know this information.
Due to volumes, some imaging departments cannot afford any downtime after cleaning.
Tip: if you know you have inpatient CT scans pending, do them first thing AM. This gets them out of the way before a Covid patient comes from the ED.
Night Shift Exams
Unless your department has a second Tech on call to help with studies, you will have to rely on other ancillary staff to get the exam done.
One Tech should not do an entire CT exam on a suspected Covid patient alone. The amount of PPE this would require is wasteful.
If there is already an ED employee gowned up and giving care to the patient, ask that they transport the patient to your CT scanner.
Then follow the procedure listed above.
It is always best to practice this workflow before it is needed to reduce mistakes and cross-contamination of staff and equipment.
Conclusion
Continue to stay educated on the latest Covid information. There may be better methodologies that the one listed above.
So, You need to be ready to adapt at a moments notice.