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Updated Guidance on the use of Ultrasound Gel - 10 Nov 2021

14th Nov 2021


The UK Health Security Agency (UKHSA) published updated guidance on the use of ultrasound gel on 10 November 2021.



Sterile ultrasound gel in single-use containers should be used in the following scenarios:

  • for invasive procedures, that is any ultrasound-guided procedure that involves passing a device through skin into sterile tissue, such as intravenous line insertion or fine needle aspirate
  • if an invasive procedure is likely to be undertaken in the following 24 hours – this includes ‘viewing or initial assessment’ of a site by ultrasound prior to undertaking an (aseptic) invasive procedure
  • where there is contact with or near to non-intact skin (any alteration in skin integrity such as a rash or surgical wound, including umbilicus in neonates)
  • where the ultrasound examination is near to an indwelling invasive device, such as an intravenous line or suprapubic catheter
  • where there is contact with a mucous membrane (for example for transrectal, transvaginal or ophthalmic procedures) – note: sterile gel to be used inside and outside of probe covers
  • for examinations on severely immunocompromised individuals
  • in an intensive-care setting, high-dependency, or equivalent unit/s, including neonatal intensive care units

Non-sterile ultrasound gel in single use and multi-patient use containers may be used:

  • during examinations in areas involving intact skin:
    • in examinations that do not involve invasive procedures
    • more than 24 hours prior to a probable invasive procedure at or near the same site


The warming of gel is not recommended unless there is a clinical benefit that outweighs applying gel at room temperature. Where warming of gel is performed:

  • use dry heat warmers instead of warm water
  • gel bottles should be kept upright in warmers and not inverted
  • warmers should be cleaned regularly according to the manufacturer’s instructions, where these exist, or clean according to local guidance


National Patient Safety Alert - UKHSA - ACTIONS REQUIRED. 



Please note the information above is not the full guidance published by the UK Health Security Agency. We only included the most relevant information for Vascular scientists. To assess the full document please visit the GOV.UK website. 

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