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Five Best Practices for Breast Imaging Technologists During the COVID-19 Pandemic

Physical distancing – a key measure to limit coronavirus infection – is nearly impossible to maintain during mammograms, breast ultrasounds and other imaging exams that require close contact between patients and professionals. However, there are a variety of steps you can take to protect the well-being of staff members responsible for obtaining top-notch images, even now.

Here are five best practices for breast imaging technologists:

Limit breast imaging to essential procedures only - The American College Radiology, American Society of Breast Surgeons, and others

All routine screening mammograms, ultrasounds and MRIs are on hold until further notice.1 According to a joint recommendation issued by the American Society of Breast Surgeons, the National Accreditation Program for Breast Centers, the National Comprehensive Cancer Network, the Commission on Cancer of the American College of Surgeons and the American College of Radiology, women who have life-threatening or symptomatic conditions requiring urgent treatment should be considered Priority A at this time. Patients who should begin treatment for a breast problem before the pandemic is over are Priority B.2

Limiting breast imaging to Priority A and B patients – including those who have severe breast abscesses and those who require biopsies of extensive lesions – will dramatically decrease the number of patients coming into the breast imaging department, thereby decreasing opportunities for staff exposure.

Implement source controls to protect staff from COVID-19 - The Centers for Disease Control

All patients (and staff) should be screened for fever and symptoms of COVID-19 (including cough, fatigue, loss of taste and smell) before they can enter the building. Anyone who has a fever or possible COVID-19 symptoms should be isolated as soon as possible for further assessment.3 If surgical masks are available, they should be given a mask to don; if surgical masks are in short supply, ask them to cover their mouth and nose with cloth, if possible.4

Visitors should not be allowed to accompany patients into the waiting room or exam areas.

Provide personal protective equipment (PPE) - The Journal of the American College of Radiology

If breast imaging technologists must conduct an exam on a patient who has or is under suspicion for COVID-19, they should wear an N95 mask, disposable isolation gown, disposable gloves and eye protection with googles, as well as a face mask, if possible, while in close contact.5 Given the current shortage of N95 masks, masks can be re-used if necessary. 6

If N95 masks are not available, breast imaging technologists should wear surgical masks and cover them with a cloth mask and/or face mask, if available.7

Use innovative scheduling to limit exposure - The Journal of Breast Imaging

Some healthcare facilities are batching patient appointments to minimize possible staff exposure. Emory University Health System, for instance, is limiting patient-facing days to two per week.8

Other facilities are using a cohort staffing model to limit exposure. At MD Anderson Cancer Center, radiologists and breast imaging technologists are split into two cohorts: one works a set number of days, and then is off while the other cohort rotates in to provide coverage.9 This approach helps ensure continued availability of healthcare personnel; if one cohort is inadvertently exposed to the novel coronavirus, the other can take over care until the first cohort can safely return to work.

Schedule adequate time for disinfection to protect against COVID-19 - The Centers for Disease Control, Food & Drugs Administration, and the World Health Organization

Many breast care centers are currently scheduling 30 minutes instead of 15 minutes for most mammograms.10 Allotting more time to each appointment allows staff (and patients) to maintain physical distancing in waiting areas and allow more time for disinfection between appointments.

All surfaces that come into contact with patients or staff should be disinfected after every appointment. The Centers for Disease Control and Prevention (CDC), Food & Drugs Administration (FDA) and World Health Organization (WHO) recommend cleaning soiled areas with soap and water before applying a disinfectant such as sodium hypochlorite, iodophor germicidal detergent solution, ethyl alcohol or isopropyl alcohol.11 Blood pressure cuffs, computer keyboards, imaging stations and tablets should also be disinfected regularly.12

Follow manufacturers’ instructions for safe disinfection of breast imaging equipment. You can find a cross-referenced list for GE Healthcare products at https://cleaning.gehealthcare.com/

For more information on mammography and the latest in women's health, visit gehealthcare.com/mammography.

RESOURCES

  1. Recommendations for Prioritization, Treatment and Triage of Breast Cancer Patients During the COVID-19 Pandemic. The COVID-19 Pandemic Breast Cancer Consortium: Representatives from the American Society of Breast Surgeons (ASBrS), the National Accreditation Program for Breast Centers (NAPBC), the National Comprehensive Care Network (NCCN), the Commission on Cancer (CoC), and American College of Radiology https://www.facs.org/-/media/files/quality-programs/napbc/asbrs_napbc_coc_nccn_acr_bc_covid_consortium_recommendations.ashx Accessed April 15, 2020.
  2. Recommendations for Prioritization, Treatment and Triage of Breast Cancer Patients During the COVID-19 Pandemic. The COVID-19 Pandemic Breast Cancer Consortium: Representatives from the American Society of Breast Surgeons (ASBrS), the National Accreditation Program for Breast Centers (NAPBC), the National Comprehensive Care Network (NCCN), the Commission on Cancer (CoC), and American College of Radiology https://www.facs.org/-/media/files/quality-programs/napbc/asbrs_napbc_coc_nccn_acr_bc_covid_consortium_recommendations.ashx Accessed April 15, 2020.
  3. Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html Accessed April 15, 2020.
  4. Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html Accessed April 15, 2020.
  5. Coronavirus (COVID-19) Outbreak: What the Department of Radiology Should Know. Journal of the American College of Radiology. https://www.jacr.org/article/S1546-1440(20)30150-2/fulltext#sec4 Accessed April 15, 2020.
  6. Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings. The National Institute for Occupational Safety and Health. https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html Accessed April 15, 2020.
  7. Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings. The National Institute for Occupational Safety and Health. https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html Accessed April 15, 2020.
  8. Response to COVID-19 in Breast Imaging. Journal of Breast Imaging. https://academic.oup.com/jbi/article/doi/10.1093/jbi/wbaa025/5814656 Accessed April 16, 2020.
  9. Response to COVID-19 in Breast Imaging. Journal of Breast Imaging. https://academic.oup.com/jbi/article/doi/10.1093/jbi/wbaa025/5814656 Accessed April 16, 2020.
  10. Response to COVID-19 in Breast Imaging. Journal of Breast Imaging. https://academic.oup.com/jbi/article/doi/10.1093/jbi/wbaa025/5814656 Accessed April 16, 2020.
  11. Coronavirus (COVID-19) Outbreak: What the Department of Radiology Should Know. Journal of the American College of Radiology. https://www.jacr.org/article/S1546-1440(20)30150-2/fulltext#sec4 Accessed April 15, 2020.
  12. Coronavirus (COVID-19) Outbreak: What the Department of Radiology Should Know. Journal of the American College of Radiology. https://www.jacr.org/article/S1546-1440(20)30150-2/fulltext#sec4 Accessed April 15, 2020.