COVID-19 guidance | Updated guidance on provision of echocardiography

This consensus statement was drafted in an attempt to ensure that exposure to viral load is minimised for sonographers. Whilst standard face masks will stop droplet spread, we are concerned that smaller particles exist within the environment that have been generated by the patient (through coughing or sneezing), or by Aerosol Generating Procedures (e.g. suction or NIV) in an asymptomatic COVID +ve patient (pre COVID diagnosis), and that this is the route of viral transmission to the sonographer. Added to this is the face to face nature and close contact of echocardiography which is different from almost all other forms of diagnostic imaging.

We understand the anxiety of sonographers and it is important we also understand the real risk to healthcare professionals as we have seen in China, Italy, now evolving in Spain and recently in the UK. Anything that can be done to minimise this will be beneficial and may avoid individual and department transmission.

There is a shortage of PPE worldwide. This makes echo triage critical to ensure that echo is only undertaken when it will make an immediate change to management. We encourage all departments to escalate triage appropriately to ensure this happens in all hospitals.

Echocardiography is not an interchangeable skill that can be provided by non-trained personnel. Keeping sonographers well (and their colleagues out of isolation) will help to deliver time dependent scans during this COVID pandemic.

For these reasons the British Society of Echocardiography have recommended that full PPE should be provided to sonographers as per the following consensus pathway.

TTE consensus pathway

We hope this consensus pathway will help our members to stratify transthoracic echocardiography within their departments. This is not intended to be a guideline but should be adapted within your own department accordingly.