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2.
Gut ; 69(11): 1915-1924, 2020 11.
Article in English | MEDLINE | ID: covidwho-724057

ABSTRACT

The COVID-19 pandemic has had a profound impact on provision of endoscopy services globally as staff and real estate were repurposed. As we begin to recover from the pandemic, a cohesive international approach is needed, and guidance on how to resume endoscopy services safely to avoid unintended harm from diagnostic delays. The aim of these guidelines is to provide consensus recommendations that clinicians can use to facilitate the swift and safe resumption of endoscopy services. An evidence-based literature review was carried out on the various strategies used globally to manage endoscopy during the COVID-19 pandemic and control infection. A modified Delphi process involving international endoscopy experts was used to agree on the consensus statements. A threshold of 80% agreement was used to establish consensus for each statement. 27 of 30 statements achieved consensus after two rounds of voting by 34 experts. The statements were categorised as pre-endoscopy, during endoscopy and postendoscopy addressing relevant areas of practice, such as screening, personal protective equipment, appropriate environments for endoscopy and infection control precautions, particularly in areas of high disease prevalence. Recommendations for testing of patients and for healthcare workers, appropriate locations of donning and doffing areas and social distancing measures before endoscopy are unique and not dealt with by any other guidelines. This international consensus using a modified Delphi method to produce a series of best practice recommendations to aid the safe resumption of endoscopy services globally in the era of COVID-19.


Subject(s)
Coronavirus Infections/prevention & control , Cross Infection/prevention & control , Endoscopy, Digestive System/statistics & numerical data , Occupational Health , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Consensus , Coronavirus Infections/epidemiology , Delphi Technique , Endoscopy, Digestive System/methods , Female , Follow-Up Studies , Humans , Incidence , Internationality , Male , Pandemics/statistics & numerical data , Patient Safety , Pneumonia, Viral/epidemiology , Risk Assessment , Time Factors , United States
7.
Dig Liver Dis ; 52(10): 1178-1187, 2020 10.
Article in English | MEDLINE | ID: covidwho-276933

ABSTRACT

The pandemic diffusion of the SARS-CoV-2 infection throughout the world required measures to prevent and strategies to control the infection, as well as the reallocation of the hospital structures in order to take care of an increased number of infected patients. Endoscopy Units should be able to perform endoscopic procedures on COVID-19 infected as well as on noninfected patients. The aim of this manuscript is to propose a model for a fast reorganization of the endoscopy department environment in order to safely perform endoscopic procedures in this Pandemic COVID-19 scenario, according to the current advices given by the Scientific Societies.


Subject(s)
Coronavirus Infections , Endoscopy, Digestive System/methods , Environment Design , Gastroenterology/organization & administration , Hospital Units/organization & administration , Infection Control/methods , Pandemics , Pneumonia, Viral , Betacoronavirus , Humans , Personal Protective Equipment
9.
Dig Endosc ; 32(5): 812-815, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-52608

ABSTRACT

COVID-19, caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), is now a global pandemic with serious health consequences. Currently, many strict control measures are applied in health care settings, including endoscopy units, in order to limit virus spread. Several recommendations called to limit endoscopic procedures to emergent endoscopies; however, several uncertainties still exist concerning patient safety, protective measures, and infection control methods in emergency endoscopic settings. In this case report, we present a case of successful endoscopic band ligation for bleeding esophageal varices in man with COVID-19 disease who presented with an acute attack of hematemesis while on mechanical ventilation (MV). Esophago-gastroduodenoscopy was performed in the ICU room after preparing the setting, and revealed large, risky esophageal varices. Endoscopic band ligation was done with successful control of bleeding. Third-level measures of medical protection were applied for the participating medical personnel, and patient monitoring was maintained all through the procedure. After the procedure, the bleeding stopped, and the patient was vitally stable and conscious. We conclude that emergency endoscopic interventions could be performed safely with appropriate arrangements in patients with confirmed COVID-19 on MV.


Subject(s)
Coronavirus Infections/diagnosis , Endoscopy, Digestive System/methods , Esophageal and Gastric Varices/complications , Esophageal and Gastric Varices/surgery , Hematemesis/surgery , Pneumonia, Viral/diagnosis , Clinical Laboratory Techniques , Coronavirus Infections/prevention & control , Emergencies , Hematemesis/etiology , Humans , Infection Control/methods , Intensive Care Units , Ligation/methods , Male , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Respiration, Artificial/methods , Risk Assessment , Treatment Outcome
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