Responsible Return to Essential and Non-Essential Surgery During the COVID-19 Pandemic

Abstract

Non-essential surgery had largely been suspended during the COVID-19 Pandemic. Enormous amounts of resources were utilized to shift surgical practices to a "disaster footing" with most elective surgeons assuming new roles to offset the anticipated burden from surgical and medical personnel delivering acute care. As the number of COVID-19-infected patients began to plateau in the state of Ohio, a four-phase "Responsible Return to Surgery" approach was adopted in concert with the Ohio Department of Health and the Ohio Hospital Association. This approach was adopted understanding that a simple return to the status quo prior to the COVID-19 pandemic might be harmful to patients, providers, and staff. The discrete phases undertaken at our quaternary care institution for a responsible return to non-essential surgery are outlined with the goal of ensuring timely care, minimizing community transmission, and preserving personal protective equipment. Operationalizing these phases relied upon the widespread use of telehealth, systematic COVID-19 testing, and real-time monitoring of hospital and personal protective equipment resources. Keywords COVID-19. Elective surgery On March 18, 2020, the Centers for Medicare and Medicaid Services published recommendations to postpone nonessential surgery and other procedures in an effort to marshal local resources and combat the spread of COVID-19.

Impact of visitor restriction rules on the postoperative experience of COVID-19 negative patients undergoing surgery

“… 22 Care teams may also consider including a discussion of visitor restriction policies and how they might impact patient recovery in the informed consent process before surgery. 23 Second, strategies aimed at decreasing social isolation and loneliness and improving psychosocial support should be implemented. Although the use of technology may overcome some of these barriers, these methods may be limited by access and familiarity to newer devices especially in vulnerable populations.…”

Emergency high ligation in a suspected COVID-19 pediatric patient with incarcerated inguinal hernia: a case report

“…However, considering the possibility of the surgeons' and other surgical team members' exposure time to anesthetic aerosols and body uids that might be contaminated with the SARS-Cov-2, it is recommended to perform the operation in the quickest and most e cient manner [17]. Furthermore, post-operative follow-up should strictly obey the tertiary protocol regulations by using full PPE [18].…”

Reactivación de la consulta y cirugía electiva durante la pandemia: recomendaciones de seguridad. Medicina Basada en Evidencia

“…Recomendaciones para la consulta 14,31,[82][83][84][85][86][87][88][89][90][91][92][93][94] • Elabore un plan de trabajo con su personal. • Comunicación con el paciente vía telefónica.…”

“…Recomendaciones para los procedimientos quirúrgicos 9,[12][13][14]31,[65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][82][83][84][85][86][87][88][89][90][91][92][93][94] • La cirugía electiva se pospone si el paciente es sospechoso o viajó a las zonas de mayor contagio. • Comprobar la desinfección del área de trabajo y de todos los aparatos que se utilicen en quirófano.…”