| Title: |
Minimizing SARS-CoV-2 exposure when performing surgical interventions during the COVID-19 pandemic |
| Authors: |
Pandey, Aditya S; Ringer, Andrew J; Rai, Ansaar T; Kan, Peter; Jabbour, Pascal; Siddiqui, Adnan H; Levy, Elad I; Snyder, Kenneth V; Riina, Howard; Tanweer, Omar; Levitt, Michael R; Kim, Louis J; Veznedaroglu, Erol; Binning, Mandy J; Arthur, Adam S; Mocco, J; Schirmer, Clemens; Thompson, Byron Gregory; Langer, David; for the Endovascular Neurosurgery Research Group (ENRG); Endovascular Neurosurgery Research Group (ENRG); Bain, Mark; Bendock, Bernard; Boulos, Alan S.; Crowley, Webster; Fessler, Richard; Grande, Andrew; Guterman, Lee; Hanel, Ricardo; Daniel Hoit; L; Hopkins, Nelson; Howington, Jay; James, Robert; Jankowitz, Brian; Khalessi, Alex A; Lanzino, Giuseppe; Lopes, Demetrius; Mack, William; Mericle, Robert; Ogilvy, Chris; Replogle, Robert; Rodriguez, Rafael; Saugaveau, Eric; Spiotta, Alex; Sultan, Ali; Tawk, Rabih; Thomas, Ajith; Turner, Raymond; Welch, Babu; White, Jonathan |
| Publisher Information: |
BMJ Publishing Group Ltd |
| Publication Year: |
2020 |
| Collection: |
HighWire Press (Stanford University) |
| Subject Terms: |
Open Surgery |
| Description: |
Background Infection from the SARS-CoV-2 virus has led to the COVID-19 pandemic. Given the large number of patients affected, healthcare personnel and facility resources are stretched to the limit; however, the need for urgent and emergent neurosurgical care continues. This article describes best practices when performing neurosurgical procedures on patients with COVID-19 based on multi-institutional experiences. Methods We assembled neurosurgical practitioners from 13 different health systems from across the USA, including those in hot spots, to describe their practices in managing neurosurgical emergencies within the COVID-19 environment. Results Patients presenting with neurosurgical emergencies should be considered as persons under investigation (PUI) and thus maximal personal protective equipment (PPE) should be donned during interaction and transfer. Intubations and extubations should be done with only anesthesia staff donning maximal PPE in a negative pressure environment. Operating room (OR) staff should enter the room once the air has been cleared of particulate matter. Certain OR suites should be designated as covid ORs, thus allowing for all neurosurgical cases on covid/PUI patients to be performed in these rooms, which will require a terminal clean post procedure. Each COVID OR suite should be attached to an anteroom which is a negative pressure room with a HEPA filter, thus allowing for donning and doffing of PPE without risking contamination of clean areas. Conclusion Based on a multi-institutional collaborative effort, we describe best practices when providing neurosurgical treatment for patients with COVID-19 in order to optimize clinical care and minimize the exposure of patients and staff. |
| Document Type: |
text |
| File Description: |
text/html |
| Language: |
English |
| Relation: |
http://jnis.bmj.com/cgi/content/short/12/7/643; http://dx.doi.org/10.1136/neurintsurg-2020-016161 |
| DOI: |
10.1136/neurintsurg-2020-016161 |
| Availability: |
http://jnis.bmj.com/cgi/content/short/12/7/643; https://doi.org/10.1136/neurintsurg-2020-016161 |
| Rights: |
Copyright (C) 2020, Society of NeuroInterventional Surgery |
| Accession Number: |
edsbas.6E310B77 |
| Database: |
BASE |