Ultrasound Gel—Moms and babies at risk

Two infectious pathogens have been found growing in bottles of ultrasound gel in Canadian health care facilities. The connection was discovered by tracing skin infections on moms and babies who had recently had ultrasounds.

Ultrasound gel is often kept in squeeze bottles left with the machines that require it. Ultrasound machines and fetal monitors are the most common places you would find the gel. It does not contain any anti-bacterial properties.

The theory is that the nozzle of the bottles are coming in contact with the patient’s skin thereby contaminating the tip and allowing the pathogens to then find a great place to grow within the bottle. Gel that is heated only speeds the process of bacterial growth. Then this gel is used on the next patient. Suggestions for preventing the spread are to ensure bottles do not have direct contact with the skin and cleaning the nozzles of the bottles with an anti-bacterial wipe after each use.

A concern which crosses the mind of a nurse is one of infections that were missed. How many new moms developed wound infections following delivery because of the ultrasound gel used on their abdomens throughout the labour or prior to their caesarean section? How many babies developed skin infections that were never traced back to the gel?

Technique is so important to the outcome of a patient's care. And more attention needs to be paid to the systems in place to prevent infection and how they are actually followed on the front line of health care.

Specialized training program too expensive?

In the North American world of obstetrics, there is a specialized program that is considered a “gold standard” of maternity care. It provides information and training sessions for the care of women during pregnancy and delivery. It is a valuable tool for teaching health care providers of all levels from obstetricians, family physicians, registered nurses, and midwives on the multitude of skills necessary for the modern practice of obstetrics. Lawyers who work on maternity cases will often ask if this program was in place to train the staff to an expected standard of care.

However, in the current environment of budget reviews and the “business” of health care that is an emerging trend in Canada, this program is about to disappear. Deemed “too expensive” by administrators, the program is expected to be gone by the end of 2009.

It takes at least two years of full-time work for a nurse new to the area to begin to feel comfortable with anything that can be thrown at her during labour and delivery. We don’t have that kind of time anymore and the training program helped fill that need of skill building because we are losing experienced care providers to retirement. They will not be there to provide the support and hands on training for a bevy of young nurses just starting to get their skills established in this very specialized area which relies very heavily on the expertise of the RN to identify and apply interventions necessary for the well-being of the mom and her baby.

Too expensive to train health care providers? How much are the two lives of mom and babe worth? How much value is there in traumatized staff who only wanted to provide the best care?