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1.
Anaesth Intensive Care ; : 310057X221092455, 2022 Jun 29.
Article in English | MEDLINE | ID: covidwho-1909955

ABSTRACT

The COVID-19 pandemic has strained surgical systems worldwide and placed healthcare providers at risk in their workplace. To protect surgical care providers caring for patients with COVID-19, in May 2020 we developed a COVID-19 Surgical Patient Checklist (C19 SPC), including online training materials, to accompany the World Health Organization Surgical Safety Checklist. In October 2020, an online survey was conducted via partner and social media networks to understand perioperative clinicians' intraoperative practice and perceptions of safety while caring for COVID-19 positive patients and gain feedback on the utility of C19 SPC. Descriptive statistics were used to characterise responses by World Bank income classification. Qualitative analysis was performed to describe respondents' perceptions of C19 SPC and recommended modifications. Respondents included 539 perioperative clinicians from 63 countries. One-third of respondents reported feeling unsafe in their workplace due to COVID-19 with significantly higher proportions in low (39.8%) and lower-middle (33.9%) than higher income countries (15.6%). The most cited concern was the risk of COVID-19 transmission to self, colleagues and family. A large proportion of respondents (65.3%) reported that they had not used C19 SPC, yet 83.8% of these respondents felt it would be useful. Of those who reported that they had used C19 SPC, 62.0% stated feeling safer in the workplace because of its use. Based on survey results, modifications were incorporated into a subsequent version. Our survey findings suggest that perioperative clinicians report feeling unsafe at work during the COVID-19 pandemic. In addition, adjunct tools such as the C19 SPC can help to improve perceived safety.

5.
World J Surg ; 45(5): 1293-1296, 2021 05.
Article in English | MEDLINE | ID: covidwho-1103425

ABSTRACT

BACKGROUND: As surgical systems are forced to adapt and respond to new challenges, so should the patient safety tools within those systems. We sought to determine how the WHO SSC might best be adapted during the COVID-19 pandemic. METHODS: 18 Panelists from five continents and multiple clinical specialties participated in a three-round modified Delphi technique to identify potential recommendations, assess agreement with proposed recommendations and address items not meeting consensus. RESULTS: From an initial 29 recommendations identified in the first round, 12 were identified for inclusion in the second round. After discussion of recommendations without consensus for inclusion or exclusion, four additional recommendations were added for an eventual 16 recommendations. Nine of these recommendations were related to checklist content, while seven recommendations were related to implementation. CONCLUSIONS: This multinational panel has identified 16 recommendations for sites looking to use the surgical safety checklist during the COVID-19 pandemic. These recommendations provide an example of how the SSC can adapt to meet urgent and emerging needs of surgical systems by targeting important processes and encouraging critical discussions.


Subject(s)
COVID-19 , Checklist , General Surgery/organization & administration , Pandemics , Delphi Technique , Humans , World Health Organization
6.
Anderegg, Loïc, Doyle, John, Gardel, Margaret L.; Gupta, Amit, Hallas, Christian, Lensky, Yuri, Love, Nancy G.; Lucas, Bronwyn A.; Mazenc, Edward, Meisenhelder, Cole, Pillarisetti, Ajay, Ranard, Daniel, Squires, Allison H.; Vechakul, Jessica, Vilas, Nathaniel B.; Williams, Stuart, Wilson, Daniel, Chen, Tyler N.; Abbas, Miral, Agalloc, James, Agarwal, Poonam, Amadei, Carlo Alberto, Altemose, Nicolas, Alves, Nathan, Anderegg, Loïc, Andrews, Katherine, Baer, Tom, Balch, Halleh, Banavar, Samhita, Bao, Yicheng, Barenberg, Sumner, Bawa, Ashvind, Bhattacharya, Arnab, Bhattacharya, Antara Raaghavi, Billings, Felicity, Blair, Daniel, Blanco-Morillo, Juan, Blobel, Nicky, Chandrakant, Ruparelia, Chen, Flora, Chen, Tyler, Cheng, Kezi, Chidsey, Chris, Cramer, Avilash, Crider, Yoshika, Crittenden, Jill, Culligan, Kieran, Cunin, Camille, los Diaz, Sabina de, Dong, Xuelai, Doshi, Siddharth, Doyle, John, El-Samad, Hana, Elsamaloty, Mazzin, Fast, Christina, Flaum, Eliott, Fleischer, Brian, Fu, Kevin, Gardel, Margaret, Geldert, Alisha, Ghanawi, Joly, Girguis, Peter, Gopal, Anjali, Grist, Samantha, Gupta, Amit, Hamilton, Rebecca, Hernandez, Matthias, Herr, Amy, Hines, Stella, Hu, Grace, Iosim, Sonia, Lebedeva, Irina, Jacobo, Andrea, Kessler, Kyle, Khlystov, Nikita, Kim, Minsoo, Konja, Marcy, Kumar, Shailabh, Kwong, Laura, Lee, Daniel, LeMesurier, Roger, Lensky, Yuri, Little, Larissa, Liu, Jason, Loutris, Amanda, Love, Nancy, Mao, Jenny, Marik, Lydia, Marini, Simone, Martin, Brie, Mathew, Joanne, Mazenc, Edward, Meisenhelder, Cole, Mondragon-Shem, Karina, Muratoglu, Orhun, Nambiar, Dhanya, Nargi, Fran, Okada, Adam, Pannu, Jassi, Parameswaran, Lalitha, Paredes-Esquivel, Claudia, Pillarisetti, Ajay, Pitchik, Helen, Plana, Deborah, Ploucha, Clare, Prakash, Manu, Preecha, Andrew, Puri, Rajan, Quaicoe, Ann, Rampazzi, Sara, Ranard, Daniel, Ray, Tyler, Reid, Bryan, Rempel, David, Robinowitz, David, Sandhu, Jaspal, Schneider, Walter, Sea, Nexus, Shless, Jared, Smullin, Sylvia, Solomon, Ari, Starr, Nichole, Styczynski, Ashley, Su, Alison, Sun, Selena, Tang, Catherine, Tham, Rachel, Tung, Maryann C.; Vilas, Nathaniel, Wang, Winnie, Weiser, Thomas G.; Wetmore, Derek, Williams, Stuart, Wilson, Robert, Yang, Helen.
Applied Biosafety ; : apb.20.0053-apb.20.0053, 2021.
Article in English | Mary Ann Liebert | ID: covidwho-1031379
8.
Trauma Surg Acute Care Open ; 5(1): e000625, 2020.
Article in English | MEDLINE | ID: covidwho-1004196

ABSTRACT

BACKGROUND: Patients hospitalized with COVID-19 are at risk of developing hypoxic respiratory failure and often require prolonged mechanical ventilation. Indication and timing to perform tracheostomy is controversial in patients with COVID-19. METHODS: This was a single-institution retrospective review of tracheostomies performed on patients admitted for COVID-19 between April 8, 2020 and August 1, 2020 using a modified percutaneous tracheostomy technique to minimize hypoxia and aerosolization. RESULTS: Twelve tracheostomies were performed for COVID-related respiratory failure. Median patient age was 54 years (range: 36-76) and 9 (75%) were male. Median time to tracheostomy was 17 days (range: 10-27), and 5 (42%) patients had failed attempts at extubation prior to tracheostomy. There were no intraprocedural complications, including hypoxia. Post-tracheostomy bleeding was noted in two patients. Eight (67%) patients have been discharged at the time of this study, and there were four patient deaths unrelated to tracheostomy placement. No healthcare worker transmissions resulted from participating in the tracheostomy procedure. CONCLUSIONS: A modified percutaneous tracheostomy is feasible and can be safely performed in patients infected with COVID-19. LEVEL OF EVIDENCE: Level V, case series.

9.
MMWR Morb Mortal Wkly Rep ; 69(34): 1166-1169, 2020 Aug 28.
Article in English | MEDLINE | ID: covidwho-732630

ABSTRACT

Although non-Hispanic American Indian and Alaska Native (AI/AN) persons account for 0.7% of the U.S. population,* a recent analysis reported that 1.3% of coronavirus disease 2019 (COVID-19) cases reported to CDC with known race and ethnicity were among AI/AN persons (1). To assess the impact of COVID-19 among the AI/AN population, reports of laboratory-confirmed COVID-19 cases during January 22†-July 3, 2020 were analyzed. The analysis was limited to 23 states§ with >70% complete race/ethnicity information and five or more laboratory-confirmed COVID-19 cases among both AI/AN persons (alone or in combination with other races and ethnicities) and non-Hispanic white (white) persons. Among 424,899 COVID-19 cases reported by these states, 340,059 (80%) had complete race/ethnicity information; among these 340,059 cases, 9,072 (2.7%) occurred among AI/AN persons, and 138,960 (40.9%) among white persons. Among 340,059 cases with complete patient race/ethnicity data, the cumulative incidence among AI/AN persons in these 23 states was 594 per 100,000 AI/AN population (95% confidence interval [CI] = 203-1,740), compared with 169 per 100,000 white population (95% CI = 137-209) (rate ratio [RR] = 3.5; 95% CI = 1.2-10.1). AI/AN persons with COVID-19 were younger (median age = 40 years; interquartile range [IQR] = 26-56 years) than were white persons (median age = 51 years; IQR = 32-67 years). More complete case report data and timely, culturally responsive, and evidence-based public health efforts that leverage the strengths of AI/AN communities are needed to decrease COVID-19 transmission and improve patient outcomes.


Subject(s)
Alaskan Natives/statistics & numerical data , Coronavirus Infections/ethnology , Health Status Disparities , Indians, North American/statistics & numerical data , Pneumonia, Viral/ethnology , Adolescent , Adult , Aged , Betacoronavirus/isolation & purification , COVID-19 , COVID-19 Testing , Child , Child, Preschool , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Middle Aged , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , SARS-CoV-2 , Severity of Illness Index , Treatment Outcome , United States/epidemiology , Young Adult
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