Post‐Procedure Perforation Rates in Ultrasound Transducer Covers Used for Ultrasound‐Guided Percutaneous Procedures in Emergency Medicine: A Comparison Between Polyurethane Covers and Polyethylene Covers

Introduction The use of sterile transducer covers for ultrasound‐guided percutaneous procedures in Emergency Medicine is common. The guidance on how transducers should be disinfected post‐procedure is much debated and has considerable cost and logistical implications. The perforation rate of transducer covers when used for percutaneous procedures in the Emergency Department setting has not previously been explored and could impact disinfection recommendations. Method This pragmatic prospective observational cohort study quantifies and compares the perforation rates of two different transducer cover types in a single Emergency Department. Details on the patient, procedure, and operator were recorded, and transducer cover perforation was retrospectively assessed by pouring a litre of water into each cover and recording details of any leakage. Results Polyethylene transducer covers had a post‐procedure perforation rate of 15.1%, more than 6 times that of polyurethane transducer covers which had a perforation rate of 2.4%. The study also shows operators are largely unaware of this perforation. Discussion Given the post‐procedure perforation rates identified, relying solely on the transducer cover as the means of infection control appears unwise, particularly as the operator is largely unaware of perforation occurring. Differences in transducer cover construction affects perforation rate. However, the chronology and aetiology of the damage are not clarified in this study, neither was resultant transducer contamination evaluated. Conclusion This single centre observational study demonstrated significant variation in post‐procedure perforation rates of two different transducer covers from a single manufacturer. Further research is required to determine the optimal probe cover and disinfection regime for infection control.