ABSTRACT
Australia avoided the worst effects of the COVID-19 pandemic, but still experienced many negative impacts. Reflecting on lessons from Australia's public health response, an Australian expert panel composed of relevant discipline experts identified the following key lessons: 1) movement restrictions were effective, but their implementation requires careful consideration of adverse impacts, 2) disease modelling was valuable, but its limitations should be acknowledged, 3) the absence of timely national data requires re-assessment of national surveillance structures, 4) the utility of advanced pathogen genomics and novel vaccine technology was clearly demonstrated, 5) decision-making that is evidence informed and consultative is essential to maintain trust, 6) major system weaknesses in the residential aged-care sector require fixing, 7) adequate infection prevention and control frameworks are critically important, 8) the interests and needs of young people should not be compromised, 9) epidemics should be recognised as a 'standing threat', 10) regional and global solidarity is important. It should be acknowledged that we were unable to capture all relevant nuances and context specific differences. However, the intent of this review of Australia's public health response is to critically reflect on key lessons learnt and to encourage constructive national discussion in countries across the Western Pacific Region.
ABSTRACT
INTRODUCTION: Point-of-care ultrasound (POCUS) has been brought to the limelight again, with a surge in lung ultrasound in suspected COVID-19 patients. This is due to POCUS superiority over chest X-ray, equivalent efficacy to computerised tomography chest for COVID-19 diagnosis and potential minimisation of cross-infection. However, inadequate disinfection practices could make ultrasound machines a vector for disease transmission. This study, conducted during the early phase of the COVID-19 pandemic, surveyed the preparedness of Australasian Clinicians for responsible POCUS practice within the Emergency Department (ED). METHODS: An anonymous online survey conducted from 20th April to 3rd June 2020 among emergency clinicians providing POCUS within Australasian EDs investigated preparedness to provide effective POCUS while minimising cross-infection. RESULTS: The survey received 171 responses and 116 being eligible for analysis. Most respondents (n = 96, 98%) had a separate 'hot zone' with a dedicated US device (n = 75, 77%), but lacked COVID-19-specific standard-operating procedures (n = 51, 52%) or a designated safety and compliance officer (n = 36, 37%). Most clinicians (n = 86, 88%) were willing to perform ultrasound in highly infectious patients, despite poor formal training (n = 66, 67%) or COVID-19-specific lung protocols (n = 59, 60%). Most (n = 92, 93%) had access to appropriate low-level disinfectant wipes but varied significantly in disinfection practice due to a lack of timely, formal or unified guidelines. CONCLUSION: Australasian EDs significantly lacked investment in education, training and protocols to conduct safe POCUS in the COVID-19 pandemic. A framework with evidence-based, logistically feasible protocols supporting safe emergency POCUS is required to deal with similar future infectious outbreaks.
ABSTRACT
The severe acute respiratory syndrome coronavirus (SARS-CoV-2), an enveloped virus, is the causative agent of the disease known as COVID-19 (coronavirus disease-2019). Proper infection prevention and control measures and good hygiene practices are essential to prevent spread of COVID-19 and protect both patients and the healthcare worker. These guidelines are relevant to all ultrasound practitioners and provides guidance on cleaning and disinfection of ultrasound equipment, the environment and PPE (protective personal equipment) during the COVID-19 outbreak in the Australasian region.
ABSTRACT
ICU ultrasonography constitutes important part of modern car patient care. Current standards and practice of infection control and prevention are inadequate. This purpose of this document is to adapt and expand the 2017 Australasian Society for Ultrasound in Medicine (ASUM) and the Australasian College for Infection Prevention Control (ACIPC) guidelines on minimum standards for reprocessing/cleaning of ultrasound transducers to the specifics of intensive care medicine and provide advice to the ICU practitioners and health care administrators. It considers the medical, administrative, financial and practical controversies surrounding implementation, and addresses emerging issues of care for patients with confirmed or suspected Corona Virus Disease 2019 (COVID-19).