We noticed a lot of concerns from the radiography community about the sanitary use of lead markers, especially on possible COVID-19 patients.  Most technologists whose facilities don’t have digital markers, have used the same lead markers for years or decades.  We surveyed our database of technologists throughout the U.S. and abroad.

Over 55% of the responding technologists work in a hospital, 24% in freestanding clinics and the remaining are in private practices, emergency clinics or other facilities.  We discovered the following practices and innovative ways to protect markers and staff.

On portables:

• 51% of technologists are still using taped on markers
• 11% use metal clip-on markers
• 26% of radiographic equipment includes digital markers assigned after exposure
• 6% of radiographic equipment assigned before exposure
• 12% of technologists use temporary or disposable markers

Disinfecting Markers:

• 18% of technologists stated they were not disinfecting their markers
• 72% are impressively using disinfectants, such as bleach, on their markers

The remaining technologists cleaned their markers with alcohol wipes or soap and water.

We discovered that over 87% of technologists have personalized markers or the digital system records their ID on images.  I was surprised to discover that at least 6% of technologists never use a form of ID on their images.

The majority or 54% of technologists are using sealed isolation bags or CR/DR image receptor covers to protect the receptors from contact with isolation patients when performing portable exams.  Almost 12% are shooting through the window of isolation rooms when the patient’s bed is positioned effectively, reducing the need to decontaminate equipment. In those cases, they have enlisted and coached the nurses in the isolation room to position the image receptor which is put in an isolation bag.

A scary 27% are not protecting the image receptor but cleaning it afterwards with disinfectant.  The remaining 7% are using a pillowcase due to lack of protective equipment options.

Kudos to the innovative technologists who offered their creative ways to protect markers and their equipment from hosting transmittable disease.  Here are some interesting ideas!

• Sticky tac on the back of markers & bleaching afterwards
• Adhesive disposable markers (some are washable and some can have your initials)
• Keeping bleach or other disinfectant wipes and gloves on the portable machine
• Isolation bags on image receptors for isolation patients
• Shooting radiographs through the ICU window when possible
• ICU units with HVAC and/or pressurized air specifications, filtrations systems and ultraviolet germicidal irradiation (A few technologists reported having to leave the image receptor in the patient room for 25-35 -minutes to kill germs before removing the isolation bag and processing the image.)

It’s always interesting to collect the data on these surveys as no technologist’s education and experience are identical.  Everyone’s methods and reasonings are largely based on their education, their mentors, geographical area and now available resources in a crisis situation.