The UK Health Security Agency (UKHSA) published updated guidance on the use of ultrasound gel on 10 November 2021. This replaced the interim guidance published in January 2021, in response to the increased awareness of infections caused by contaminated non-sterile ultrasound gel products.
The SoR and the SoR ultrasound advisory group were involved in the development of this guidance along with a wide range of stakeholders.
On 11 November the Medicine and Healthcare products Regulatory Agency (MHRA) released a national patient safety alert, which clarifies the actions required to reduce harm and practice safely.
The UKHSA guidance states that sterile single use gel sachets should be used when invasive procedures are to be performed during the examination, or likely to be within the next 24 hours, as decontamination of the skin does not fully remove gel.
For examinations on non-intact skin or where contact with mucous membranes occur, eg transvaginal or transrectal scans, sterile gel should be used both inside and outside the probe cover, as small perforations may be present in probe covers. Any examination taking place on severely immunocompromised individuals or in high dependency settings also require sterile gel.
Other advice is provided, including that non-sterile gel should not be decanted from larger gel containers. Gel bottles should be dated when opened and used within one month, unless the expiry date is earlier. The tip of the gel bottle should be wiped with a disinfectant wipe between use and gel should be removed from the individual’s skin, ideally with a cleaning wipe, or low-risk outpatients should be advised to wash with soap and water when they return home.
Warming of gel is not advised but where it is, and the benefit outweighs the risk, dry heat warmers should be used with the bottle stored in the upright position.
The environmental impact was discussed during the development of the guidance and NHS Supply Chain colleagues will be discussing this with manufacturers.
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