Subject(s)
COVID-19 , Cardiac Catheterization/standards , Cardiac Catheterization/trends , Forecasting , HumansABSTRACT
As the world slowly starts to recover from the coronavirus disease-2019 pandemic, health care systems are now thinking about resuming elective cardiovascular procedures, including procedures in cardiac catheterization laboratories. Rebooting catheterization laboratories will be an arduous process, in part because of limited health care resources, new processes, and fears stemming from the coronavirus disease-2019 pandemic. The authors propose a detailed phased-in approach that considers clinical, patient-centered, and operational strategies to safely and effectively reboot catheterization laboratory programs during these unprecedented times. This model balances the delivery of essential cardiovascular care with reduced exposure and preservation of resources. The guiding principles detailed in this review can be used by catheterization laboratory programs when restarting elective interventional procedures.
Subject(s)
Betacoronavirus , Cardiac Catheterization/standards , Cardiac Surgical Procedures/standards , Coronavirus Infections/complications , Delivery of Health Care/standards , Laboratories, Hospital/standards , Pneumonia, Viral/complications , Practice Guidelines as Topic , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Elective Surgical Procedures/standards , Humans , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , SARS-CoV-2Subject(s)
Cardiac Catheterization/methods , Coronavirus Infections/epidemiology , Patient Care/methods , Pneumonia, Viral/epidemiology , COVID-19 , Cardiac Catheterization/standards , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Disease Outbreaks , Humans , Pandemics/prevention & control , Patient Care/standards , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Risk FactorsSubject(s)
Cardiac Catheterization/standards , Coronavirus Infections/prevention & control , Disease Transmission, Infectious/prevention & control , Infection Control/standards , Myocardial Infarction/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Aerosols/adverse effects , COVID-19 , Cardiopulmonary Resuscitation/adverse effects , Cardiopulmonary Resuscitation/standards , Coronavirus Infections/etiology , Coronavirus Infections/transmission , Hospital Units/standards , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Intubation, Intratracheal/adverse effects , Intubation, Intratracheal/standards , Patient Selection , Percutaneous Coronary Intervention/adverse effects , Percutaneous Coronary Intervention/standards , Personal Protective Equipment/standards , Pneumonia, Viral/etiology , Pneumonia, Viral/transmission , Practice Guidelines as Topic/standards , Resource Allocation/standards , Suction/adverse effects , Suction/standardsABSTRACT
The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly infectious, carries significant morbidity and mortality, and has rapidly resulted in strained health care system and hospital resources. In addition to patient-related care concerns in infected individuals, focus must also relate to diminishing community spread, protection of staff, case selection, and concentration of resources. The current document based on available data and consensus opinion addresses appropriate catheterization laboratory preparedness for treating these patients, including procedure-room readiness to minimize external contamination, safe donning and doffing of personal protective equipment (PPE) to eliminate risk to staff, and staffing algorithms to minimize exposure and maximize team availability. Case selection and management of both emergent and urgent procedures are discussed in detail, including procedures that may be safely deferred or performed bedside.