Infection prevention and control in ultrasound - best practice recommendations from the European Society of Radiology Ultrasound Working Group.

OBJECTIVES: The objective of these recommendations is to highlight the importance of infection prevention and control in ultrasound (US), including diagnostic and interventional settings. METHODS: Review of available publications and discussion within a multidisciplinary group consistent of radiologists and microbiologists, in consultation with European patient and industry representatives. RECOMMENDATIONS: Good basic hygiene standards are essential. All US equipment must be approved prior to first use, including hand held devices. Any equipment in direct patient contact must be cleaned and disinfected prior to first use and after every examination. Regular deep cleaning of the entire US machine and environment should be undertaken. Faulty transducers should not be used. As outlined in presented flowcharts, low level disinfection is sufficient for standard US on intact skin. For all other minor and major interventional procedures as well as all endo-cavity US, high level disinfection is mandatory. Dedicated transducer covers must be used when transducers are in contact with mucous membranes or body fluids and sterile gel should be used inside and outside covers. CONCLUSIONS: Good standards of basic hygiene and thorough decontamination of all US equipment as well as appropriate use of US gel and transducer covers are essential to keep patients safe. MAIN MESSAGES: • Transducers must be cleaned/disinfected before first use and after every examination. • Low level disinfection is sufficient for standard US on intact skin. • High level disinfection is mandatory for endo-cavity US and all interventions. • Dedicated transducer covers must be used for endo-cavity US and all interventions. • Sterile gel should be used for all endo-cavity US and all interventions.

Undergraduate radiology teaching from the student's perspective.

OBJECTIVES: To obtain medical students' evaluation of the quality of undergraduate radiology teaching received, preferred teaching methods and resources. This is a follow-up project to an earlier study of junior doctors who felt that radiology teaching left them ill prepared for medical practice. METHODS: A questionnaire to third and fifth year medical students undertaking clinical rotations at Newcastle University, UK. RESULTS: The questionnaire was completed by 57/60 (95 %) of third and 37/40 (93 %) of final year medical students. Students received minimal radiology teaching in pre-clinical years, feeling this was insufficient. The majority of students rated interactive case-based teaching as effective. Self-directed learning resources such as textbooks, journals and even online learning modules were perceived as less effective. Other types of web resources rated higher. Motivation for most students when studying radiology was to achieve learning objectives needed to pass their next exams and/or to improve as a doctor. CONCLUSIONS: Medical students criticise the lack of radiology teaching in pre-clinical undergraduate years. Radiology teaching should be represented in all undergraduate years, preferably delivered via interactive teaching sessions. Currently available e-learning modules do not meet the students' learning needs and there is a call for reliable, up-to-date open access electronic resources. MAIN MESSAGES: • Radiology teaching should be represented in all pre-clinical and clinical undergraduate years. • Medical students rate interactive case-based teaching sessions as very effective. • There is a call for reliable, up-to-date open access electronic resources for medical students.

Radiology teaching for junior doctors: their expectations, preferences and suggestions for improvement.

OBJECTIVES: To evaluate radiology teaching offered to junior doctors on general medical/surgical rotations, their preferences regarding teaching methods and self-directed learning tools, and their suggestions for improvement. METHODS: An online questionnaire involving all foundation programme doctors at Sunderland Royal Hospital was carried out. Quantitative analysis of preferences and free text feedback were used. RESULTS: There was a response rate of 88/90 doctors (98%). The radiology teaching received was mostly informal. Most junior doctors felt that their medical school radiology teaching had been inadequate. The preferred teaching techniques were interactive case-based and system-based discussions. Textbooks and journal articles were not as popular as self-directed learning tools. Online learning material was used quite frequently, with general web content being more popular. Eighty-seven percent cited their motivation for studying radiology as "to become a better doctor". More guidance from radiologists was desired, particularly regarding the choice of examinations and discussion of cases. Twenty-two percent of doctors were considering radiology as a career. CONCLUSIONS: Interactive elements in radiology teaching are important. Online electronic teaching modules can be integrated into the teaching curriculum, but they must be of high quality to be acceptable and face-to-face interaction is still important. Junior doctors would like more guidance from radiologists.

Rapid assessment of abdominal aortic aneurysms by 3-dimensional ultrasonography.

OBJECTIVE: The purpose of this study was to assess the application and accuracy of 3-dimensional (3D) volume acquisition ultrasonography in the measurement of abdominal aortic aneurysms (AAAs). METHODS: Thirty consecutive patients undergoing surveillance ultrasonographic examinations of known AAAs were scanned according to a conventional protocol, after which 3D volume data sets were acquired with a commercially available mechanical transducer. Maximum aortic diameters were measured with multiplanar reconstructions from the 3D volume data, and these were compared with those from the conventional technique. RESULTS: Abdominal aortic aneurysm diameters were between 2.9 and 6.75 cm. For both anteroposterior and transverse diameters, a paired t test showed a Pearson correlation coefficient of 0.98 (significant at the P = .01 level) and a coefficient of determination of 0.96. Bland-Altman analysis showed that the mean difference between the two sets of measurements was very close to 0 (P = .05). Thus, there was no significant difference between the conventional and 3D volume measurement methods. The scan acquisition time for the 3D volume data was only 3 seconds for each set (anteroposterior and transverse). CONCLUSIONS: Three-dimensional ultrasonography using volume acquisition offers a new opportunity to acquire fast and reliable AAA measurements. The reduced scan times can be used to allow greater patient throughput and will help cope with the increasing workload of AAA surveillance. By archiving a complete set of data, 3D ultrasonography allows subsequent analysis and comparison of measurements. This study also suggests that the technique could be used for other applications with similar efficiency gains.