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Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2

OBJECTIVES: In many countries around the world, the COVID-19 pandemic has resulted in health services being diverted to manage patients with the condition. There are situations however that still require the undertaking of aerosol generating procedures (AGP) with potentially high exposure of healthc...

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Autores principales: Soma, Marlene, Jacobson, Ian, Brewer, Jessica, Blondin, Angela, Davidson, Gretel, Singham, Shamani
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier B.V. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194841/
https://www.ncbi.nlm.nih.gov/pubmed/32388083
http://dx.doi.org/10.1016/j.ijporl.2020.110075
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author Soma, Marlene
Jacobson, Ian
Brewer, Jessica
Blondin, Angela
Davidson, Gretel
Singham, Shamani
author_facet Soma, Marlene
Jacobson, Ian
Brewer, Jessica
Blondin, Angela
Davidson, Gretel
Singham, Shamani
author_sort Soma, Marlene
collection PubMed
description OBJECTIVES: In many countries around the world, the COVID-19 pandemic has resulted in health services being diverted to manage patients with the condition. There are situations however that still require the undertaking of aerosol generating procedures (AGP) with potentially high exposure of healthcare workers to SARS-CoV-2 transmission through droplet, contact and possibly airborne routes. The objective of this paper is to explore a structured way for the operative team to approach AGP to reduce aerosolisation of secretions, decrease open airway time and minimise staff exposure. METHODS: The authors (otolaryngologists, anaesthetists and nursing staff) created a unified operative team checklist based on collation of national and international specialty society statements, local state government recommendations, hospital policies and literature review. Simulation was undertaken and the checklist was refined after performing AGP on patients with unknown (presumed positive) COVID-19 status. RESULTS: An 8 step operative team checklist is provided describing details for the immediate pre-operative, intra-operative and post-operative journey of the patient to encourage healthcare workers to reflect upon and modify usual practice during AGP to mitigate exposure to SARS-CoV-2. The example of paediatric laryngo-bronchoscopy for diagnostic purposes or retrieval of an inhaled airway foreign body is used to illustrate the steps however the checklist structure is modifiable for other AGP and adaptable for local needs. CONCLUSIONS: At a time of overwhelming and changing information and recommendations, an operative team checklist may provide some structure to healthcare workers undertaking AGP to reduce anxiety, maintain focus, prompt consideration of alternatives and potentially reduce risk.
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spelling pubmed-71948412020-05-02 Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2 Soma, Marlene Jacobson, Ian Brewer, Jessica Blondin, Angela Davidson, Gretel Singham, Shamani Int J Pediatr Otorhinolaryngol Article OBJECTIVES: In many countries around the world, the COVID-19 pandemic has resulted in health services being diverted to manage patients with the condition. There are situations however that still require the undertaking of aerosol generating procedures (AGP) with potentially high exposure of healthcare workers to SARS-CoV-2 transmission through droplet, contact and possibly airborne routes. The objective of this paper is to explore a structured way for the operative team to approach AGP to reduce aerosolisation of secretions, decrease open airway time and minimise staff exposure. METHODS: The authors (otolaryngologists, anaesthetists and nursing staff) created a unified operative team checklist based on collation of national and international specialty society statements, local state government recommendations, hospital policies and literature review. Simulation was undertaken and the checklist was refined after performing AGP on patients with unknown (presumed positive) COVID-19 status. RESULTS: An 8 step operative team checklist is provided describing details for the immediate pre-operative, intra-operative and post-operative journey of the patient to encourage healthcare workers to reflect upon and modify usual practice during AGP to mitigate exposure to SARS-CoV-2. The example of paediatric laryngo-bronchoscopy for diagnostic purposes or retrieval of an inhaled airway foreign body is used to illustrate the steps however the checklist structure is modifiable for other AGP and adaptable for local needs. CONCLUSIONS: At a time of overwhelming and changing information and recommendations, an operative team checklist may provide some structure to healthcare workers undertaking AGP to reduce anxiety, maintain focus, prompt consideration of alternatives and potentially reduce risk. Published by Elsevier B.V. 2020-07 2020-04-29 /pmc/articles/PMC7194841/ /pubmed/32388083 http://dx.doi.org/10.1016/j.ijporl.2020.110075 Text en Crown Copyright © 2020 Published by Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Soma, Marlene
Jacobson, Ian
Brewer, Jessica
Blondin, Angela
Davidson, Gretel
Singham, Shamani
Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2
title Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2
title_full Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2
title_fullStr Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2
title_full_unstemmed Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2
title_short Operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to SARS-CoV-2
title_sort operative team checklist for aerosol generating procedures to minimise exposure of healthcare workers to sars-cov-2
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194841/
https://www.ncbi.nlm.nih.gov/pubmed/32388083
http://dx.doi.org/10.1016/j.ijporl.2020.110075
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