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Decontaminating Ultrasound Probes

Q: Our office leaves the ultrasound probe in an open gallon container of glutaraldehyde as they use the probe throughout the day. Are there other options for decontamination of the probe? Can we just wipe it down with alcohol? Any suggestions?

A: Using glutaraldehyde for this purpose is overkill (literally) and unnecessarily exposes workers to toxic fumes. Of the three levels of cleaning--sterilization (autoclaving), high-level disinfection and low-level disinfection--an ultrasound probe requires the lowest level. Since it doesn't enter a patient's sterile body cavity (if it did, you would autoclave) or touch a patient's mucous membranes (then you would have to sterilize or high-level disinfect using glutaraldehyde), you can clean it just like any other item that touches patient skin and is used from patient to patient (blood pressure cuffs, stethoscopes, etc.). A low-level disinfectant such as 70% to 90% ethanol or isopropanol, iodine and iodophors, phenols and phenolics, or 1:100 dilution of bleach (1 teaspoon in 2 cups water) will do the trick in your case. Check the manufacturer's instructions to be sure whichever disinfectant you select doesn't ruin the probe and void your warranty.

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Posted by Quality America on December 30, 2005 | Comments (16)


What about transvaginal probes?

Posted by: at February 27, 2006 09:36 AM

Any device that enters a patient's mucous membranes must undergo high level disinfection between patients. High level disinfectants are all glutaraldehydes: cidex, metricide, etc. Depending upon the type of probe, it might be able to be autoclaved, however, it would be best to follow the manufacturer's instructions.

Posted by: Sheila Dunn at March 16, 2006 03:58 PM

Recently, I have had several Physician's labs ask about large collectors being on the floor. All of the containers in question have an open lid. Are there any regulations for the labs to have these in a sharps trolley or off the floor. This has been my recommendation, due to liablity.

Posted by: Cathy McCreless at March 23, 2006 06:47 AM

Biohazardous waste containers should have covered lids, but there is no regulation requiring that they be placed up off the floor. In fact, a "step can" is ideal for biohazardous waste.

Posted by: Dr. Dunn at April 3, 2006 03:16 PM

I am a student and I am working at a clinic where they use cidex and put the transvaginal probe in a container that has cracked and they have had to replace it within half a year. They do not use a "ventilation system" and the only place I go uses t-spray and leaves it to dry for 10 min. or more. Which place is doing it correctly?

Posted by: melinda george at April 21, 2006 12:46 PM

To see if T-spray is adequate, check the probe manufacturer's operator's manual to see how they recommend disinfection between patients. If a glutaraldehyde solution is required, remember that you can't use CIDEX/METREX without either a ventilation system OR ensuring that the soaking system is closed tightly at all times unless inserting or removing the probe.
Hope this helps!

Posted by: Dr. Dunn at April 25, 2006 03:48 PM

Can a transvaginal ultrasound probe be covered with a condom instead of cleaning between uses? I have recently seen this and didn't think that sounded at all appropriate.

Posted by: Lori Tucker at May 23, 2006 07:14 PM

We recommend high-level disinfection after every procedure, based on a recent study indicating that latex condoms often fail (6.9%) and that visual inspection is inadequate 5% of the time. In this study, 8 (5%) of 173 cases were contaminated when using latex condoms only, and in only 3 of these 8 cases was gross contamination seen. Contamination can occur by a defect in the condom or leakage of blood or other body fluids at the open rim of the condom.

So, in addition to using sterile condoms as sheaths, follow the manufacturer's instructions by disinfecting the transducer probe for 10 minutes in a bactericidal solution between examinations.

Source: Southern Medical Journal. February 1997. Ineffectiveness of Latex Condoms in Preventing Contamination of the Transvaginal Ultrasound Transducer Head. John M. Storment, MD, Manju Monga, MD, And Jorge D. Blanco, MD, Houston, Tex.

Posted by: Sarah Alholm at June 2, 2006 10:22 AM

Regarding transvaginal ultrasonography, is T-spray II considered a highlevel disinfectant? Although the manufacturer's do not state what is in it, the spectrum of activity does not imply high-level disinfection.

Posted by: Dr Susan Knowles at June 2, 2006 10:24 AM

Per the manufacturer, Pharmaceutical Innovations, T-Spray II is not considered a high-level disinfectant. T-Spray II is a dual chain quaternary ammonium product and is considered a mid-level disinfectant. Pharmaceutical Innovations can be contacted at 973-242-2900.

Posted by: Sarah Alholm at June 2, 2006 10:25 AM

All of our ultrasound exams are performed using the transvaginal ultrasound probe. The doctor I work for believes that it is sufficient to just spray the probe with a disinfectant and wipe it clean. Can you tell me where I can print out documentation on cleaning transvaginal ultrasound probes?

Posted by: Judy Maloney at June 15, 2006 12:33 PM

The American Institute of Ultrasound in Medicine has a published statement on cleaning transvaginal ultrasound probes. Since the probe touches a patient's mucous membranes, you must perform high-level disinfection using glutaraldehyde (or an equivalent product).

Print out the official AIUM statement from this link:

Posted by: Sarah Alholm at June 15, 2006 12:34 PM

what about transvaginal / transrectal ultrasound probes?

Posted by: April Wigginton at August 1, 2006 01:15 PM

Transrectal probes have the same cleaning requirements as transvaginal probes. Check out the blog postings from March 16, 2006 and June 2, 2006 for more details on cleaning transvaginal and transrectal probes.

Posted by: Sarah Alholm at August 2, 2006 11:26 AM

I was wondering if a case of infection due to transvaginal or transrectal probes have been reported ?

Posted by: Clément Deshays at March 8, 2007 05:49 AM

I am not aware of any reports, but this research definately indicates the possibility exists if probes are not being high-level disinfected between patients:



Has anyone seen any cases of disease transmission through this route?

Posted by: Sarah Alholm at March 8, 2007 11:09 AM

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