Anaesthesia and COVID-19: infection control

Abstract

The world is currently facing an unprecedented healthcare crisis caused by a pandemic novel beta coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pathogen is spread by human-to-human transmission via droplets exposure and contact transfer, causing mild symptoms in the majority of cases, but critical illness, bilateral viral pneumonia, and acute respiratory distress syndrome (ARDS) in a minority. Currently, controlling infection to prevent the spread of SARS-CoV-2 is the primary public healthcare intervention used. The pace of transmission and global scale of SARS-CoV-2 infections has implications for strategic oversight, resource management, and responsiveness in infection control. This article presents a summary of learning points in epidemiological infection control from the SARS epidemic, alongside a review of evidence connecting current understanding of the virologic and environmental contamination properties of SARS-CoV-2. We present suggestions for how personal protective equipment policies relate to the viral pandemic context and how the risk of transmission by and to anaesthetists, intensivists, and other healthcare workers can be minimised.

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

“…The protection level of the surgical gowns depends on the type of procedure [76] . An filtering face pieces (FFP) 2 mask filters 94% of all particles that are 0.3 mm in diameter or larger; while N95 masks block 95% and FFP3 masks block 99% [77] . A class 2 or 3 FFP face mask should be worn when working in close contact with patients with suspected or confirmed COVID-19, and only to use surgical face masks in a crisis scenario of shortage of FFP 2 and 3 respirators [78] .…”

“…Airborne transmission risks are high during aerosol generating procedures such as laparoscopy, endoscopy and tracheal incubation to exposure patients' oropharynx and airway secretions with a high viral load [79] . We suggest that surgical team members, including anesthesiologists, surgeons and operating nursing staff should ware highly protective levels of PPE when treating patients known to have been infected with COVID-19 [77] . Most recent information from Italy reported that 12% of healthcare workers were infected at the beginning of COVID-19 pandemic [67] , and this incidence was greatly reduced when PPE was used properly and infection control measures were followed [80] .…”

Cardiopulmonary exercise testing in the COVID-19 endemic phase

“…An additional consideration is that CPET does not incorporate bacterial and viral filters to collect exhaled particles. The potential to produce infected droplets from a positive COVID-19 patient will increase the risk of both airborne and surface transmission 14,15 and needs consideration regarding the potential for protracted viral shedding (i.e. the test lasts <10 min).…”

Triage and management of aortic emergencies during the coronavirus disease 2019 (COVID-19) pandemic: A consensus document supported by the American Association for Thoracic Surgery (AATS) and Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS)

“…Early intubation before transport should be considered for patients requiring-high flow oxygen (>15 L/min) or noninvasive ventilation. 3 Patients may be transported on low-flow oxygen sources (such as nasal cannula, simple facemask, or non-rebreather mask). Face masks should be worn by the patient, including over any airway devices.…”

“…Early intubation before transport should be considered for patients requiring-high flow oxygen (>15 L/min) or noninvasive ventilation. 3 …”