What considerations and infection precautions need to be taken for trauma and acute care surgeries during the pandemic?

Bottom Line:

For patients with suspected or confirmed COVID-19, any emergency surgery should be carried out with the appropriate infection precautions, proper screening before the surgery and conducted in a negative pressure operating room. After any emergency surgery, all patients should be monitored closely for infection and anticoagulation therapy is recommended for trauma patients with COVID-19 (except if there is a reason not to administer).

Reference:

Gong, Y. et al. Anesthesia Considerations and Infection Precautions for Trauma and Acute Care Cases During the COVID-19 Pandemic. Anesthesia & Analgesia (2020). DOI: 10.1213/ANE.0000000000004913

Date Published:

24 April 2020

Synopsis:

At the present, most hospitals across the country have postponed surgeries that are non-emergent cases. Surgeries—even the safest ones—leave patients in a vulnerable state at risk of getting infections after their surgery. While this delay is frustrating for many folks who have been waiting for their surgeries, it helps reduce the risk of getting a COVID-19 infection while at the hospital for patients. Some surgeries, however, such as emergency trauma are inevitable. This article aims to address what infection precautions need to be taken by the healthcare workforce to help reduce the risk to the patient. Patients with a history or clinical symptoms related to COVID-19 are recommended to receive a chest computed tomography (CT) scan, complete blood count and a test for COVID-19 prior to beginning the operation. Any surgery involving an infected patient should be carried out under strict infection precautions with the recommended PPE. Also, the choice of anesthesia in patients with suspected or confirmed COVID-19 should consider factors such as the patient’s overall situation, trauma condition, and surgical procedure—ideally, regional anesthesia is recommended when possible in these patients. After the surgery, all patients (including those who screened negative for COVID-19) should be watched closely for potential infection and any visitation should be strictly limited to prevent the possibility of infection.

Summary by: Brintha Sivajohan