Informed surgical consent during the COVID‐19 pandemic: Exploring the risk of unknown

Avci²,

Harran Üniversitesi Tıp Fakültesi Dergisi

2023

Background: The study aimed to figure out whether, how, and why the COVID-19 pandemic has changed physicians’ attitudes toward informed consent in Turkey. Materials and Methods: An online questionnaire was distributed to physicians through the snowball sampling method and 528 physicians treating COVID-19 patients turned in the questionnaire. Findings: Most of the physicians (n= 317) indicated that the COVID-19 pandemic has influenced their attitudes on informed consent, while 39.96% of them (n= 211) stated that the pandemic did not change their behaviors on informing patients and/or families. An overwhelming majority of the physicians (n= 259) emphasized the impact of the higher mortality rate of the disease, the lack of standard treatment for the disease, and the higher demand from patients and families for information on providing patients and/or families with more information. On the other hand, 18.30% (n= 58) of the physicians admitted that the pandemic has caused them to disclose less information because of the lack of time to provide information, the need for urgent treatment, and the lack of information regarding the risks, benefits, and outcomes of applied treatments. Conclusion: COVID-19 pandemic affected the majority of the physicians attitudes and behaviors toward informed consent.

Section: Discussionmentioning

confidence: 99%

The Impact of the Covid-19 Pandemic on Physicians in Turkey Towards Informed Consent

Avci²,

Harran Üniversitesi Tıp Fakültesi Dergisi

2023

“…Its first wave in early 2020 caught the medical community with no pertinent guidelines or standard operation procedures on hand. Swift implementation of unprecedented management strategies was required to maintain a basic level of surgical and anesthetic care [ 3 , 4 , 21 , 22 ], and surgical procedures had to be cancelled in large numbers to keep intensive care resources in supply and protect medical staff [ 10 , 23 , 24 ]. Given the paramount role of social distancing in bringing down infection rates, the focus was on minimizing contacts between staff and patients.…”

Section: Discussionmentioning

confidence: 99%

“…Coronavirus disease 2019 (COVID- 19) was declared a pandemic by the World Health Organization (WHO) on March 11 th , 2020 [1]. Since its outbreak, many healthcare providers have been forced to modify their standard procedures to meet the special challenges arising from the crisis [2][3][4][5][6][7][8][9]. Elective surgery was postponed extensively and treatment of outpatients dramatically reduced [10,11].…”

Section: Introductionmentioning

confidence: 99%

Ad-hoc preoperative management and respiratory events in pediatric anesthesia during the first COVID-19 lockdown–an observational cohort study

et al. 2022

Background Early pre-anesthetic management for surgery is aimed at identifying risk factors, which notably in children are mostly airway related. The first COVID-19 lockdown opened a unique ‘window of opportunity’ to study what impact an ad-hoc management strategy would bring to bear on intraoperative respiratory events. Methods In this observational cohort study we included all patients with an American Society of Anesthesiology (ASA) Physical Status of I or II, aged 0 to ≤18 years, who underwent elective surgery at our center during the first national COVID-19 lockdown (March 15th to May 31st, 2020) and all analogue cases during the same calendar period of 2017−2019. The primary outcome parameter was a drop in peripheral oxygen saturation (SpO2) below 90% during anesthesia management. The study is completed and registered with the German Clinical Trials Register, DRKS00024128. Results Given 125 of 796 evaluable cases during the early 2020 lockdown, significant differences over the years did not emerge for the primary outcome or event counts (p>0.05). Events were exceedingly rare even under general anesthesia (n = 3) and non-existent under regional anesthesia (apart from block failures: n = 4). Regression analysis for SpO2 events <90% yielded no significant difference for ad-hoc vs standard preoperative management (p = 0.367) but more events based on younger patients (p = 0.007), endotracheal intubation (p = 0.007), and bronchopulmonary procedures (p = 0.001). Conclusions Early assessment may not add to the safety of pediatric anesthesia. As a potential caveat for other centers, the high rate of anesthesia without airway manipulation at our center may contribute to our low rate of respiratory events.

“…The pandemic status and the national lockdown have created delays in both diagnosis and surgical treatment of cancer (Vecchio et al 2020 ), leading patients to undergo surgery at more advanced stages of the oncological pathologies (Garg et al 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular tissue banking activity during SARS-CoV-2 pandemic: evolution of national protocols and Lombardy experience

et al. 2021

The worldwide pandemic outbreak due to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has created unprecedented challenges for public health services. Lombardy, region of the Northern Italy, has been the first area in the Western world whose organs and tissues procurement programs have had to face the virus pandemic emergency. We retrospectively collected and analyzed data about cardiovascular tissues (CT) in 2019 and in 2020. We aimed to describe the rapid evolution of SARS-CoV-2 regulation laws for tissue donor’s selection and harvesting from February 2020 until January 2021. As expected the number of CT donors in 2020 was significantly lower than those of 2019 (66 vs. 99, p value 0.02). The total number of CT collected from donors have been 254 in 2019 and 206 in 2020 ( p 0.28). Femoral arteries were the most required vascular tissues (55.5% in 2019 and 40% in 2020). Fifty-five and forty-eight pulmonary valves were implanted in 2019 and 2020, respectively. No differences were found for the types of CT requests between the 2 years. The median age of receivers of vascular tissues was 69.6 ± 14.6 years in the 2019 and 63.3 ± 14.9 years in 2020 ( p < 0.01). The median age of receivers of pulmonary and aortic valves did not differ between the 2 years (9.32 ± 11.49 vs. 8.36 ± 10.66 and 48.67 ± 27.19 vs. 37.14 ± 31.97 respectively). Despite the dramatically reduction of donors, the number of CT collected has not decreased significantly and so far the CT distribution rate is comparable to those of 2019.