COVID-19 outbreak: less stethoscope, more ultrasound
This safety should be guaranteed from the patient’s first assessment. In fact, maintaining the safety of the doctor, who meets many people during his daily activity, avoids the spread of the disease to other patients and the possible creation of new epidemic outbreaks. However, patients with fever and respiratory symptoms do still need to be seen. The standard method involves doing an objective examination and carrying out any radiological tests, such as chest radiography or chest CT. This means the use of tools such as a stethoscope and radiological devices, with the possibility of contamination of the medical devices and nosocomial spreading of the virus; eventually, this can cause the contagion of health-care workers (from doctor to nurse to radiology technicians) and already hospitalised patients who have a higher risk of developing severe COVID-19.
His famous article entitled “Is lung ultrasound the stethoscope of the new millennium? Definitely yes” was visionary in 2016 and now, in this historical period, very pertinent.
The paediatrician prepares the ultrasound pocket device, which comprises a wireless probe and a tablet. The probe and tablet are placed in two separate single-use plastic covers (figure). No other medical devices are used. When the two operators enter the isolation room, the paediatrician uses the probe and does the lung ultrasound, the assistant holds the tablet and freezes and stores the images, touching neither the patient nor the surrounding materials. The stethoscope is not used because it is more difficult to have specific covers and there is a higher probability to mistakenly touch either the ocular or oral mucosa with it. Lung auscultation is therefore substituted by lung visualisation with the ultrasound. After the procedure, in a dedicated area, the operators easily remove the probe and tablet from the covers, simply letting them slip onto clean towels, where the devices are further sterilised.