ASNM provides guidance on things that IONM professionals can and should do now to continue to prudently provide care to patients.
AANEM's COVID-19 Resource Page provide guidance for patient interaction, managing NCS/EMG testing procedures and requests for testing during COVID-19. Resources also include coding, guide to the CARES Act and rescheduling patient visits.
Disinfecting equipment: Following standard precautions for disinfecting equipment is recommended using appropriate PPE.
Consider a wipeable cover on electronics or place a clear plastic bag over equipment. Follow manufacturer’s instruction for cleaning and disinfecting. If not available, use either 70% isopropyl alcohol (IPA) with a lint free wipe, Cavi-wipe or Super Sani-Cloth (or equivalent solution). Thoroughly wipe all surfaces and inspect for visible residue. If residues remain, use a new Super Sani-Cloth (or equivalent solution) or lint free wipe soaked with 70% IPA and continue wiping the surfaces until visibly free of residue. Allow for appropriate dwell or dry time as per the manufacturer’s recommendations.
Click on this hyperlink to find the current list of products that meet the Environmental Protection Agency ’s criteria for use against Sars-CoV-2, and click on this hyperlink for COVID-19 Fighting Products announced by the American Chemistry Council and the Center for Biocide Chemistries (updated 3/25/2020).
The CDC also recommends cleaning surfaces with soap and water wearing disposable gloves. High touch surfaces that require attention include tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, sinks, etc. Click here for more information.
For equipment used in rooms with COVID-19 patients (both suspected and confirmed cases), following the University of Maryland cleaning procedures have been recommended. These procedures include cleaning and disinfecting EEG equipment TWICE (details and full procedure are found here).
Disinfecting electrodes: Disposable electrodes are recommended for use if possible, with disposal of all single use items such as measuring tapes, marking pencils etc. Sterilize reusable electrodes between use or follow manufactures instructions for cleaning, then disinfect using approved high-level disinfectants such as a diluted sodium hypochlorite solution (100 pp) for up to 60 minutes.
Measuring tape: Single-use or nonretractable measuring tape is recommended. If using retractable measuring tape, it is vital to ensure the tape is properly cleaned using a product (EPA or ACC approved) per manufacturer’s directions and air dried before retraction. Remember, wiping/cleaning equipment between patients is vital regardless of diagnosis or status. Best practices are to wipe equipment fully upon exiting a patient’s room using approved disinfectant and clean gloves. Follow the product manufacturer’s recommendation for dwell/dry time.
COVID-19 resource: Managing requests for neurodiagnostic testing per ACNS
Patient management: Outpatient/non-essential/non-urgent procedures are recommended to be triaged by the referring provider and deferred to a future date. If considered urgent, phone screen the patient on symptoms and exposure risks. If response is negative, the test can be performed with universal standard precautions as usual. All inpatient procedures are recommended for triage to determine emergent status. EEG is based on patient state of consciousness and evident signs of seizures. If patient is still pending labs on COVID19, wait the 24-48 hours prior to performing the EEG. Use any downtime for additional cleaning and disinfection of laboratory space and equipment.
Strategies for optimizing the supply of PPE: Click on this hyperlink for CDC’s guidelines for eye protection, isolation gowns, facemasks and N95 respirators. Copied below are strategies recommended by the National Academy of Medicine that all neurodiagnostic technologists should be aware of:
Additional conservation and re-use techniques should be considered when the PPE is in shortage, including:
Leading through COVID-19, an eight-part learning series: Click on hyperlink to Watch On Demand: Cultivating personal resilience amid volatility; Leading in a time of crisis: Social distancing without revenue disruption; Keeping your people engaged and productive through the crisis; Protecting your company’s economic health; Employing agile reward strategies for a volatile world; Crisis-proofing your talent processes; Creating effective learning experiences in a virtual environment
Human Resources Compliance: IRS Guidance on Tax Credits for Paid Leave; Questions and Answers on Human Resources Flexibilities and Authorities for Coronavirus Disease 2019 (COVID-19); and the Society of HR Management for more information related to HR and COVID-19