Ebola and radiology: Open and frequent communication among staff essential for safety

The arrival of the Ebola virus in the United States this year caught at least one medical facility off guard and has prompted officials to rethink response protocols when it comes to the highly fatal, infectious disease.

In a report written by David A. Bluemke, MD, PhD, of Johns Hopkins Hospital in Baltimore, and Carolyn C. Meltzer, MD, of Emory School of Medicine in Atlanta, and published in Radiology, the authors outline important protocols for radiology departments to implement in light of this year’s Ebola incidents, including the October death of a man in Texas who had recently returned from a trip to West Africa.

“Clear and frequent communication with the healthcare staff is essential during this time of heightened public concern and understandable caution,” Meltzer said in a press release.

The United States has four biocontainment sites for Ebola patients: Emory University Hospital in Atlanta; NIH Clinical Center in Bethesda, Md.; St. Patrick Hospital in Missoula, Mont.; and Nebraska Medical Center in Omaha, and medical imaging plays a vital role in excluding diseases and ailments other than Ebola.

“At present, the role of medical imaging in [Ebola] is supportive: to exclude other diagnoses or assess complications of the [disease],” Bluemke and Meltzer wrote.

Report authors stress the best way to protect medical staff and still provide the highest level of patient care is to perform all imaging examinations in an isolation unit.

“Radiology departments must develop standard operating procedures for performing imaging procedures in an isolation unit,” the authors said in a press release. “Details of the standard operating procedure will vary, depending on the type of equipment available, whether the facility is equipped for wired or wireless image transmission, and complexity of the examination.”

The report authors note two current strategies used for imaging in the case of infectious diseases. In one, the exam takes place inside the “hot” room with the patients. Radiology technicians stay in the “warm” room (anteroom) and provide instructions on equipment use to medical staff inside the hot room with the patient.

In the case of more complicated equipment or extenuating circumstances, the radiology technician enters the hot room to perform the exam.

No matter what, Bluemke and Meltzer stress, every effort should be made to avoid transporting the patient out of the hot room.

Another strategy the authors suggest is presenting hospital cleaning policies to radiology equipment manufacturers to ensure the steps are satisfactory. Additionally, the report calls for double bagging equipment to protect sensitive surfaces and electronics. Bluemke and Meltzer note that CT and MR equipment are not designed for imaging patients with infectious diseases.

“Bodily fluids easily accumulate in narrow recesses that are inaccessible to surface cleaning,” the authors wrote, citing a mock scanning session held this year that resulted in the tearing of an isolation pod by moving parts of a CT scanner.