Neurotrauma in the Time of SARS-COV 2: A Checklist for Its Safe Management

Abstract

Neurotrauma is a critical public health problem that deserves the attention of the world health community. The unprecedented pandemic of SARS-COV 2 has led to a tremendous strain on medical facilities including intensive care and availability of blood products. In addition, due to lockdown in most nations and diverting of medical attention elsewhere, neurotrauma has taken a back seat. Despite this, any case of trauma presenting during this time should receive the best possible care. However, it is also imperative to safeguard the health care workers from this infection, too. The number of health care workers losing their lives to this infection is ever rising. We here present a possible workflow using a checklist approach such that errors and cross-infections are minimized and there is no reduction in the level of care received by any trauma case. This article has been written with a special focus on middle-income countries where resources may already be strained due to the sudden case burden. We hope to minimize death “caused” by COVID-19 and “related” to it.

Algorithm of traumatic brain injury management at Indonesia in the COVID 19 pandemic ERA. Retrospective cohort study

“…Screening is a crucial initial step in this pandemic period, not only for COVID patients, but also all patients who enter the emergency room. During a pandemic, all patients must undergo COVID-19 screening and be treated as a suspected COVID-19 until proven different [ 4 , 8 ].…”

“…The operating room must be disinfected before and after use with disinfectant solutions. Disposable surgery material is used for patients who are confirmed to be COVID-19 [ 4 , 6 , 8 ].…”

“…This is done to minimize the risk of exposure. The strict use of level III PPE must be used for surgery of confirmed or suspected COVID-19 patients [ 4 , 17 ].…”

“…TBI is also associated with high morbidity and mortality rates and high treatment costs. Therefore, management of TBI cases, especially in emergency rooms, is very important and crucial to determine patient outcomes [ 4 , 5 ].…”

Anesthetic Management of Neurosurgery Patients in COVID-19 Pandemic in an Emergency Setting

“… 1 Ensuring training of healthcare workers regarding donning and doffing of personal protective equipment (PPE) and conducting simulation exercises are essential to ensure compliance to protocol, especially in emergencies like management of neurotrauma. 2 We believe the protocol is well made and may benefit from some modifications in institutions dealing with neurosurgical emergencies and trauma.…”