Tablet Based Limited Echocardiogram to Reduce Sonographer Scan and Decontamination Time During The COVID-19 Pandemic

McMahon, Sean R.; DeFrancis, Garett; Schwartz, Sara; Duvall, William L.; Arora, Bhaskar; Silverman, David I.

Background Limited assessments with handheld ultrasound have found meaningful clinical use in the care of acutely ill patients. However, there are limited data on incorporating handheld based limited echocardiograms into the echocardiogram laboratory. The purpose of this study is to assess the efficacy of a limited handheld tablet echocardiogram as an alternate to traditional echocardiography during the COVID-19 pandemic as a means to limit exposure while providing essential clinical information. Methods Ninety consecutive inpatients with known or suspected COVID-19 infection were scanned according to laboratory COVID-19 guidelines using a limited 11-20 clip protocol on a tablet sonograph. The primary assessment was length of study time. Comparison data was drawn from comprehensive echocardiograms ordered on intensive care patients not under COVID-19 precautions. Results Over a 36 day time period there were a total of 91 requests deemed to be appropriate for echocardiography on COVID-19 positive or suspected patients (average age: 67, 64% male, body mass index 32kg/m2). Of these, ninety (99%) were performed on a handheld device and all were deemed diagnostic and provided sufficient information for the clinical care team. Sonographer scan time decreased from an average of 24±6.8min on a traditional platform to 5.4±1.9min on a tablet. Conclusions Limited handheld echocardiography can be successfully implemented in the echocardiography laboratory for screening of COVID related cardiac conditions. The protocol performed with handheld tablet ultrasound provides adequate diagnostic information of major cardiac complications of COVID-19 infection while decreasing sonographer contact and simplifying decontamination.