https://doi.org/10.1177/0267659120986532 Perfusion 1–12 © The Author(s) 2021 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0267659120986532 journals.sagepub.com/home/prf Introduction The novel coronavirus, SARS-Cov-2, is highly conta- gious posing potential risk to healthcare professionals. 1 In response, higher thresholds to perform bedside echocardiography have been widely adopted to limit risk of cross-infection. 2,3 Technological advancement has seen the development of handheld ultrasound devices capable of delivering point of care cardiac assessment. Ease of use and decontamination, together with its portability and low cost have highlighted its unique role in the current clinical era. 4,5 Handheld echocardiography (HHE) can be a valuable clinical tool in rapidly assessing the haemodynamic effects and guiding subsequent management of the ensuing COVID-19 clinical syndrome. 6,7 This article sum- marises the evolving role of HHE during a pandemic. We propose a protocol with a reporting template, using a focused core dataset necessary in delivering an acute echocardiography service in the setting of a highly con- tagious disease, where risk to the operator is minimised. We cover the scenarios typically encountered in the acute cardiology setting and how an expert trained echocardiography team can correctly identify such pathologies using a limited imaging format. Adapting the role of handheld echocardiography during the COVID-19 pandemic: A practical guide Hafiz Naderi, 1 Shaun Robinson, 2 Martin J Swaans, 3 Nina Bual, 1 Wing-See Cheung, 1 Laura Reid, 1 Matthew Shun-Shin, 1 Perviz Asaria, 1 Punam Pabari, 1 Graham Cole, 1 Gajen S Kanaganayagam, 1 Nilesh Sutaria, 1 Michael Bellamy, 1 Kevin Fox, 1 Petros Nihoyannopoulos, 1 Ricardo Petraco, 1 Rasha Al-Lamee, 1 Sukhjinder S Nijjer, 1 Sayan Sen, 1 Neil Ruparelia, 1 Christopher Baker, 1 Ghada Mikhail, 1 Iqbal Malik, 1 Ramzi Khamis, 1 Amanda Varnava, 1 Darrel Francis, 1 Jamil Mayet 1 and Bushra Rana 1 Abstract The COVID-19 pandemic has altered our approach to inpatient echocardiography delivery. There is now a greater focus to address key clinical questions likely to make an immediate impact in management, particularly during the period of widespread infection. Handheld echocardiography (HHE) can be used as a first-line assessment tool, limiting scanning time and exposure to high viral load. This article describes a potential role for HHE during a pandemic. We propose a protocol with a reporting template for a focused core dataset necessary in delivering an acute echocardiography service in the setting of a highly contagious disease, minimising risk to the operator. We cover the scenarios typically encountered in the acute cardiology setting and how an expert trained echocardiography team can identify such pathologies using a limited imaging format and include cardiac presentations encountered in those patients acutely unwell with COVID-19. Keywords handheld echocardiography; pandemic; COVID-19; practical guide 1 Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, London, UK 2 North West Anglia NHS Foundation Trust, Peterborough, Cambridgeshire, UK 3 Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands Corresponding author: Hafiz Naderi, Echocardiography Department, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK. Email: hafiz.naderi@nhs.net 986532PRF 0 0 10.1177/0267659120986532PerfusionNaderi et al. review-article 2020 Review