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Email Id : info@ascend-care.com
 
 
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Ultrasound Gel - Infection Issue
A Study & Solution
To Receive a free copy of this study paper - Please fill and submit the Request form
Ultrasound equipments
INTRODUCING FOR THE FIRST TIME IN INDIA
 
 
Neogel is Tested and approved by major ultrasound equipment manufacturers, NEOGEL has been a trusted product from the time it was introduced in the Market.

ASCEND CARE’S unique manufacturing process produces gels free of air bubbles.
Air bubbles in gel cause scattering and reflection of the sound waves, resulting in potential performance degradation of ultrasound imaging.
 
Neogel Features
  • Has acoustic properties that minimize refraction through the skin while optimizing coupling and has excellent acoustic conduction.
  • Contains no silicones, surfactants, alcohol, or mineral oil – which can harm transducers, probes, and scan heads.
  • Contains no dyes, fragrance or propylene glycol or any known skin irritants. Hence it is Non–allergenic and Non–irritant to skin.
  • The salt stabilized formula reduces gel thinning and run-off from patient perspiration, making it very smooth and consistent and very easy to wipe off after the procedure.
  • Is Water soluble
  • Is pH balanced
  • Is Pleasant & odorless
  • Does not stain on clothes
 
Instructions for use
  • For External Use Only
  • Store In Cool & Dry Place
  • Keep Away From Direct Sun Light
 
Contents
  • Preservatives
  • Thickeners
  • De –Ionised Aqua

For Best results - It is recommended to wipe off sweat on the skin with a tissue before Gel application

 
STERILE ULTRASOUND GEL with Transducer Sheath / Probe cover
Intended Use
  • All invasive procedures
  • All procedures done in the intensive care units.
  • All procedures in which a device is passed through tissue (e.g., Fine needle aspiration, needle localization, tissue biopsy).
  • All procedures involving a sterile environment.
  • All procedures on non intact skin or open wounds.
  • All procedures on neonates.
  • All procedures involving contact with mucous membranes (e.g., oesophageal, gastric, rectal,vaginal).
  • All operative procedures.
  • All procedures in patients with immune deficiencies.
  • All procedures in patients on immunosuppressive therapy.
 
NEOGEL TRANSDUCER SHEATH STROKE PROBE COVER FEATURES
All NEOGEL COMBI-PACK STERILE include an ultrasound Transducer Sheath or Probe cover for every application.

NEOGEL Transducer Sheath or Probe cover are made typically from latex-free material, non-toxic polyethylene material or thin polymer foil that are cut to appropriate size and shape.

These Transducer Sheaths or Probe covers are sterile for use with transducer or probe or scan head instrument.

Our ultrasound Transducer Sheath or Probe covers are supplied alongwith sterile ultrasound gel which is a good conductor to display images of tissues and body cavities.

The gel is applied on the surface of the Transducer Sheath or Probe cover to ensure elimination of bubbles or air which hinders production of good image.

The NEOGEL COMBI-PACK STERILE offers various benefits such as cost-effectiveness, saves time, promotes efficient work flow, reduces maintenance cost thereby reducing labor cost of the clinical set-up and eliminates task of disinfection.

Sterile Ultrasound Transducer Sheath or Probe covers are often used during Fine Needle Aspiration and Biopsies since they possess the highest degree of sterility thus protecting the patient from acquiring any complication.

In addition to this, trans vaginal probes that are often used in different gynecological procedures require sheaths or covers with greater texture somoothness in producing excellent images to target organs therefore Transducer Sheath or Probe cover hold the key in maintaining safety and sterility.

Transducer Sheath or Probe covers provide so much benefit to help Doctors, medical staff as well as patients to adhere in the improvement of one’s health and safety.

 
Transducer Cover WARNING
  • All single-use Transducer Sheath or Probe cover must be disposed as infectious waste.
  • All single-use Transducer Sheath or Probe must not be reused, reprocessed or re-sterilized. Re-use, re-processing or re-sterilization may create a risk of contamination of the sheath /cover, causing patient infection or cross-infection.
  • Use only NEOGEL provided in the sterile sachet. Other water based, petroleum or mineral and oil based gels may harm the sheath cover and the transducer.
  • All sterile and disposable components are for single-use only.
  • Do not use if expiration date has passed.
  • For disposable components labeled sterile, do not use if integrity of package is violated.
  • All manufacturer instructions and warnings are printed on the product Label.
 
Covering the transducer or probe or scan head instrument
  • Transducer Sheath or Probe cover have to be used to cover Transducer probes to protect patients from contamination, since ultrasound probes themselves cannot be easily sterilized.
  • Air has to be eliminated from the Transducer Sheath or Probe cover , because it is a bad ultrasound conductor. To avoid air bubbles, it is necessary to partially fill Transducer Sheath or Probe cover with ultrasound gel.
  • Always use a sterile cover over the transducer to protect patients and users from cross contamination.
  • Place an appropriate amount of gel inside cover and/or on transducer face. Poor imaging may result if no gel is used.
  • Insert transducer into the sheath cover making sure to use proper sterile or aseptic techniques and protocols.
  • Pull cover tightly over transducer face to remove wrinkles and air bubbles, taking care to avoid puncturing the sheath cover. (For more information please refer to our User guideline.)
  • Secure cover with the Elastic bands provided in pack. Also a cable to sheath or cover Tie is provided in certain products with long Transducer Sheath or Probe covers, to make sure that the sheath or cover does not slip or move forward exposing the transducer cable while conducting the procedure.
  • Inspect Transducer Sheath or Probe cover to ensure there are no holes or tears.
 
NEOGEL COMBI-PACK STERILE WITH ONE END CLOSED SHEATH
PRODUCT CODE - UGCPS30-CE
The sterile pack contents:
  • Ultrasound Gel 30 ml Sachet - 1 No.
  • Transducer Sheath / Probe Cover with One Closed End - 1 No.
  • Elastic Bands - 2 Nos.
  • Sheath to Cable Tie - 1 No.
 
The Neogel 'CE' Transducer Sheath or Probe cover is a protective sheath or cover placed over an ultrasound transducer or probe or scan head instrument.
  • It is designed to protect the transducer during Invasive and Non-Invasive Ultrasonography.
  • It is pliable but resistant and provides distortion free imaging.
  • It is Non-Spermicide, Non-Embryotoxic, and Non-Cytotoxic.
  • It is 100 % Latex free.
  • It is Odourless.
  • It is Non - allergic.
  • It is Non - lubricated.
  • It is with a very smooth texture with natural skin feel.
  • It is highly sensitive.
  • It is 100% free of pinholes.
  • It is powder or gel free.
  • It is absolutely bio-safe and prevents cross infection amongst patients.
  • It can be used with the transducer in scanning and Fine Needle Guided procedures for body surface, endo-cavity, intra-operative diagnostic or therapeutic ultrasound.
  • It helps to prevent transfer of micro-organisms, body fluids, and other material to the patient and doctor.
  • It is sterile for use with transducer or probe or scan head instrument, providing a means for a sterile field.
  • It has sufficient width to accommodate varied transducer sizes and allows use with all ultrasound transducer types used during sterile procedures.
  • It has the highest degree of sterility thus protecting the patient from acquiring any complication.
  • Provides so much benefit to help Doctors, medical staff as well as patients to adhere in the improvement of one’s health and safety.
 
Applying and Usage Technique for One end closed sheath
Step 1
Step 2
Step 3
     
 
Illustration One
Illustration Two
 
 
NEOGEL COMBI-PACK STERILE WITH BOTH ENDS OPEN SHEATH
PRODUCT CODE - UGCPS30-OE
The sterile pack contents:
  • Ultrasound Gel 30 ml Sachet - 1 No.
  • Transducer Sheath / Probe Cover with One Closed End - 1 No.
  • Elastic Bands - 2 Nos.
  • Sheath to Cable Tie - 1 No.
 
The Neogel 'OE' Transducer Sheath or Probe cover is a protective sheath or cover placed over an ultrasound transducer or probe or scan head instrument.
  • It is designed to protect the transducer during Invasive and Non-Invasive Ultrasonography.
  • It is pliable but resistant and provides distortion free imaging.
  • It is Non-Spermicide, Non-Embryotoxic, and Non-Cytotoxic.
  • It is 100 % Latex free.
  • It is Odourless.
  • It is Non - allergic.
  • It is Non - lubricated.
  • It is with a very smooth texture with natural skin feel.
  • It is highly sensitive.
  • It is 100% free of pinholes.
  • It is powder or gel free.
  • It is absolutely bio-safe and prevents cross infection amongst patients.
  • It can be used with the transducer in scanning and Fine Needle Guided procedures for body surface, endo-cavity, intra-operative diagnostic or therapeutic ultrasound.
  • It helps to prevent transfer of micro-organisms, body fluids, and other material to the patient and doctor.
  • It is sterile for use with transducer or probe or scan head instrument, providing a means for a sterile field.
  • It has sufficient width to accommodate varied transducer sizes and allows use with all ultrasound transducer types used during sterile procedures.
  • It has the highest degree of sterility thus protecting the patient from acquiring any complication.
  • Provides so much benefit to help Doctors, medical staff as well as patients to adhere in the improvement of one’s health and safety.
 
USER GUIDELINE FOR NEOGEL COMBI - PACK STERILE- with Both Ends Open Sheath
 
NEOGEL COMBI-PACK STERILE WITH PROBE SHEATH FOR VAGINAL/RECTAL
PRODUCT CODE - UGCPS30-VR
The sterile pack contents:
  • Ultrasound Gel 30 ml Sachet - 1 No.
  • Transducer Sheath/Probe Cover Specially Designed for Vaginal or Rectal Probes - 1 No.
  • Elastic Bands - 3 Nos.
  • Sterile Towel - 1 No.
 
The Neogel 'VR' Transducer Sheath or Probe cover is a special protective sheath or cover placed over an Vaginal or Rectal ultrasound transducer or probe or scan head instrument.
  • It is designed to protect the transducer during Trans-Vaginal or Trans-Rectal Ultrasonography.
  • It is pliable but resistant and provides distortion free imaging.
  • It is Non-Spermicide, Non-Embryotoxic, and Non-Cytotoxic.
  • It is 100 % Latex free.
  • It is Odourless.
  • It is Non - allergic.
  • It is Non - lubricated.
  • It is with a very smooth texture with natural skin feel.
  • It is highly sensitive.
  • It is 100% free of pinholes.
  • It is powder or gel free.
  • It is absolutely bio-safe and prevents cross infection amongst patients.
  • It can be used with the transducer in scanning and Fine Needle Guided procedures for body surface, endo-cavity, intra-operative diagnostic or therapeutic ultrasound.
  • It helps to prevent transfer of micro-organisms, body fluids, and other material to the patient and doctor.
  • It is sterile for use with transducer or probe or scan head instrument, providing a means for a sterile field.
  • It has sufficient width to accommodate varied transducer sizes and allows use with all ultrasound transducer types used during sterile procedures.
  • It has the highest degree of sterility thus protecting the patient from acquiring any complication.
    Provides so much benefit to help Doctors, medical staff as well as patients to adhere in the improvement of one’s health and safety.
 
Applying and Usage Technique for Vaginal or Rectal Sheath
  • Apply a small Quantity of Sterile Gel inside the Sheath
  • Insert the clean and dry Transducer Probe until it reaches the distal tip of the sheath or probe cover
  • On completion of the procedure, remove the Transducer sheath or probe cover by turning it inside out, so that the contaminated part remains inside for a safe and hygenic discarding.
  • Same procedure may be followed for rectal examinations also.
 
Step 1
Step 2
 
     
 
Step 3
Step 4
 
 
 
NEOGEL ULTRASOUND GEL STERILE
PRODUCT CODE - UGS30
The sterile pack contents:
  • Ultrasound Gel 30 ml Sachet - 1 No.
This pack is only Sterilzed Gel and is supplied without any other contents in the pack.
 
NON-STERILE ULTRASOUND GEL
PRODUCT CODE - UGNS30
The NEOGEL Single Patient Dispenser Pack
  • The Ultrasound Gel is supplied in a 30 ml pack.
  • This is Non-Sterile Gel supplied in Single Patient Dispenser packs for Individual Patient Examination
 
The Unit Dose Delivery System
Ascend Care has developed the single unit dose packaging for its NEOGEL used in ultrasonography as an alternative to the standard gel dispensing squeeze bottle.
The Single Patient Dispensing Packaging is for easy opening and dispensing.
It can be warmed in a standard ultrasound gel warmer with no concerns of micro-organism growth and warms faster than a 250 ml bottle.
 
Patient Safety
Prevents Nosocomial infection from ultrasound gel and bottles
NEOGEL Single Patient Dispenser Pack prevents the spread of ultrasound gel based infection by eliminating the opportunity for cross-contamination from the refilled gel contents and / or the bottle surface.
 
Eliminates repetitive motions that result in – Work Related
Musculoskeletal Disorders in Sonography (WRMSD)
Society of Diagnostic Medical Sonography (SDMS) recommends that gel bottles have large
openings to reduce the strength needed to squeeze the bottle and be of suitable diameter to avoid extended grip position.

NEOGEL Single Patient Dispenser Pack eliminates bottle shaking and squeezing and
unscrewing the cap for opening to further minimize repetitive motion.
 
Reduces Microbiological contamination of ultrasound equipment / probes
NEOGEL Single Patient Dispenser Pack eliminates risk of cross contamination from the
equipment to the patient or from the patient to the equipment.
 
User Information & Assistance
Our Main Concern is to “Protect Every Patient” or to say “Protect your Patients”
We have sincerely attempted to point out the issues concerning the use of Ultrasound Gels on Patients from Multiple Patient Dispensing Packs which are currently used and available in the Market.
 
Gel Dispenser - The bottle problem....
gel dispenserEveryday, ultrasound gel bottles are exposed to hospital air, equipment, human skin and body fluids possibly contaminating the gel and potentially leading to patient cross-contamination and infection.
The common practice of refilling partially emptied gel bottles results in mixing clean gel with gel that has been exposed to pathogens. Mixing contaminates the entire contents of the bottle.
Bottles are commonly used for the storage, and dispensing of ultrasound gel. Unfortunately, when bottles are exposed to body fluids, they can become contaminated with a wide range of pathogens that can be transmitted to another patient during a subsequent procedure.
Simply wiping the bottles before refilling from a bulk container does not guarantee that both the interior/exterior surfaces and the left over gel are contaminant free.
Using small, disposable bottles, is expensive, laborious and time consuming. Even the most thorough disinfection protocol can only address the exterior of the gel bottle.
 
Microbiological contamination of ultrasound equipment & probes ...
microbiological contaminationUltrasound equipment comes into direct contact with patients and practitioners during scanning procedures, enabling it to be a potential vehicle for the spread of nosocomial infections.
The most significant contamination is found on the non-invasive equipment, probably due to the lower level of decontamination practices designated for this equipment.
Related Studies reveal that, if any part of the ultrasound equipment is contaminated, be that the ultrasound transmission media (gel), (which acts as a coupling medium that enables the transmission of sound from the ultrasound probe through into the patient’s body and back again), the probe that is placed onto the gel to scan, or even the keyboard the practitioners touch during scanning, then there is a risk of cross contamination from the equipment to the patient.
It also revealed high levels of contamination on the equipment, such as S. aureus (60% of which were methicillin-resistant) Acinetobacter species, Candida albicans and Bacillus species.
 
So, what could be a possible solution?
Single Patient dispenser packs which are non-sterile or sterile, disposable single unit doses of ultrasound scanning gel packs designed specifically to eliminate the possibility of cross contamination from refilled gel bottles.
 
If so, What could be the possible Savings ?

Medical ImagingMoney - Single Patient dispenser packs cost less per ml of gel than most scanning gels sold in a 250 ml squeeze bottle or 5 liter economy cans.
Gel - The Single Patient dispenser packs empty completely, eliminating gel waste. The pack's design reduces plastic waste to a considerable extent.
Reduce Microbial contamination on equipment & probes - The Single Patient dispenser packs minimize ultrasound equipment / probe contamination, caused by the ultrasound transmission media gel, which acts as a coupling medium that enables the transmission of sound from the ultrasound probe through into the patient’s body and back again reducing the risk of cross contamination from the equipment to the patient and vice versa.
Time - Single Patient dispenser packs save time by eliminating time wasted in washing and refilling bottles. Simply apply the gel from the Single Patient dispenser packs on the patient and discard.
Require no additional equipment - Single Patient dispenser packs can be warmed in your current warmer with no concern of microorganism overgrowth as with reused and contaminated gel bottles.
Reduce Sonographer Work Related Injuries - Single Patient dispenser packs reduce filling, shaking, and squeezing gel bottles which contributes to repetitive motion musculoskeletal injury or fatigue.
Reduce Hospital / Facility Liability - Single Patient dispenser packs reduce liability as Risk Managers and Infection Control Specialists agree that Single Patient dispenser packs reduce sonographer related injury or fatigue and the possible potential for patient contamination from ultrasound gel.

 
Advantages in using Sterile and Single Dispenser Packed Gel

Single Use Ultrasound GelAlthough not completely analogous to the Spaulding classification regarding the level of risk associated with patient care, a classification system of Sonography gel may be a
rational way to categorize the uses of sterile and non sterile Sonography gel.

One such system of classification could be that critical procedures require sterile gel, semi-critical procedures require sterile gel, and noncritical procedures require non-sterile gel ideally from single-use containers or packs.

Several institutions and hospitals have policies in place that exceed this categorical scheme and require the use of sterile gel on all Sonography procedures that involve neonates, patients with immune deficiencies, and/or patients on immunosuppressive therapy.
If gel is being used on a patient who is in droplet or contact isolation, the use of a single-use gel pack is warranted, so that the gel container and its contents could be discarded after the Sonography procedure.

Especially when it comes to vaginal and rectal sonograms, Spaulding’s semi-critical category does not mandate sterility for these two types of procedures, but it does indicate a standard of high-level disinfection / caution and at least the use of gel from single dispension pack for such procedures.

Thus, sterile gel supersedes Spaulding’s semi-critical classification.
It is important to note that most Sonography equipment manufacturers recommend that all intracavity examinations are done with use of sterile probe sheath and sterile gel.
This is a topic that needs clarification, especially with the documented evidence of sterile and non sterile probe cover failure.

At minimum, the gel used within the intracavity probe sheath should come from a container that is kept separate from general examination exposure and not placed in a bottle warmer.
In regard to the more invasive vaginal and rectal procedures such as vaginal biopsy, ovum retrieval, or prostate biopsy, the use of sterile gel within a sterile probe cover should be considered. Sterile gel should be used during other procedures such as biopsies and drainages, including amniocenteses.

 
A simple Comparison Study
Ultrasound Probe SheathNEOGEL Single Patient Dispenser Pack is less expensive per unit than most 250 ml bottles and 5-Liter containers.
The most common & prevalent mode of Ultrasound Gel is Dispensed by using 250 ml squeeze bottles, which are refilled or topped up from 5 Liter cans.
We have to consider that this expense (Non-Revenue)for the cost of the Gel is paid for by the Hospital or facility, though it is generally believed and fully accepted that the Gel cost is either very insignificant or is taken care of by the scanning cost charged to and paid by the patient.
Now, let us consider what difference it makes to the Hospital or Facility if they start using the NEOGEL Single Patient Dispenser Pack.
All Single patient Dispenser packs are supplied to the Pharmacy or the retail outlet attached to the Hospital or Facility.
Hence,
  • The Hospital or the facility need not spend money in buying their gel and stocking the same.
  • The patient for whom scanning is recommended pays to the pharmacy a very insignificant amount and buys the gel pack and waits for his / her turn for scanning. Just as the patient buys a bottle of water for filling his / her bladder before scanning.
  • The Hospital or facility makes a clear profit on every sale of gel to the patient through the Pharmacy or the retail outlet, just as they earn profits on sale of Drugs and Medicines to patients.
  • Hence, the clear and sound evidence that the Hospital or facility can hence forth make profit in usage of Gel for scanning on each patient in addition to their scanning fees is established.
 
FINALLY - - - -
Ascend care will make sure that the Hospital or facility earn what they currently spend on the cost of buying and stocking gel.
The Economic advantages for the Hospital or facility using NEOGEL Single Patient Dispenser Pack is that they
  • Ultrasonography in ChennaiProtect their patients from all possible cross-patient contamination or infection.
  • Eliminate noscomial infection potential from refilling and reusing gel bottles.
  • Protect the sonologist or technicians from musculoskeletal injury or fatigueness.
  • Reduce possible liabilities & threats to hospitals or facilities.
  • Reduce Microbiological Contamination on Equipment & Probes.
  • Promote safety and ease of use.
  • Make profit on use of gel by converting EXPENSE to REVENUE.
 
 
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