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Minimizing SARS-CoV-2 exposure when performing surgical interventions during the COVID-19 pandemic.
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.
  • Pandey AS; Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA adityap@med.umich.edu.
  • Ringer AJ; Neurosurgery, Mayfield Clinic, University of Cincinnati, Cincinnati, Ohio, USA.
  • Rai AT; Interventional Neuroradiology, West Virginia University Hospital, Morgantown, West Virginia, USA.
  • Kan P; Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
  • Jabbour P; Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
  • Siddiqui AH; Neurosurgery, University at Buffalo, Buffalo, New York, USA.
  • Levy EI; Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
  • Snyder KV; Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA.
  • Riina H; Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA.
  • Tanweer O; Neurosurgery and Neurology and Canon Stroke and Vascular Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
  • Levitt MR; Department of Neurosurgery, New York University - Langone Medical Center, New York, New York, USA.
  • Kim LJ; Department of Neurosurgery, New York University - Langone Medical Center, New York, New York, USA.
  • Veznedaroglu E; Neurological Surgery, Radiology and Mechanical Engineering, University of Washington, Seattle, Washington, USA.
  • Binning MJ; Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.
  • Arthur AS; Drexel Neuroscience Institute and GNI, Philadelphia, Pennsylvania, USA.
  • Mocco J; Drexel Neurosciences Institute, Philadelphia, Pennsylvania, USA.
  • Schirmer C; Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA.
  • Thompson BG; Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
  • Langer D; The Mount Sinai Health System, New York, New York, USA.
J Neurointerv Surg ; 12(7): 643-647, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-327010
Semantic information from SemMedBD (by NLM)
1. 2019 novel coronavirus COEXISTS_WITH COVID-19
Subject
2019 novel coronavirus
Predicate
COEXISTS_WITH
Object
COVID-19
2. Virus CAUSES COVID-19
Subject
Virus
Predicate
CAUSES
Object
COVID-19
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Practitioner DIAGNOSES Pyotraumatic dermatitis
Subject
Practitioner
Predicate
DIAGNOSES
Object
Pyotraumatic dermatitis
5. Neurosurgical Procedures TREATS COVID-19
Subject
Neurosurgical Procedures
Predicate
TREATS
Object
COVID-19
6. Neurosurgical Procedures TREATS Patients
Subject
Neurosurgical Procedures
Predicate
TREATS
Object
Patients
7. 2019 novel coronavirus COEXISTS_WITH COVID-19
Subject
2019 novel coronavirus
Predicate
COEXISTS_WITH
Object
COVID-19
8. Virus CAUSES COVID-19
Subject
Virus
Predicate
CAUSES
Object
COVID-19
9. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
10. Practitioner DIAGNOSES Pyotraumatic dermatitis
Subject
Practitioner
Predicate
DIAGNOSES
Object
Pyotraumatic dermatitis
11. Neurosurgical Procedures TREATS COVID-19
Subject
Neurosurgical Procedures
Predicate
TREATS
Object
COVID-19
12. Neurosurgical Procedures TREATS Patients
Subject
Neurosurgical Procedures
Predicate
TREATS
Object
Patients
ABSTRACT

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.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Health Personnel / Infectious Disease Transmission, Patient-to-Professional / Coronavirus Infections / Neurosurgical Procedures / Betacoronavirus Type of study: Clinical Practice Guide Limits: Humans Language: English Journal: J Neurointerv Surg Year: 2020 Document Type: Article Affiliation country: Neurintsurg-2020-016161

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Health Personnel / Infectious Disease Transmission, Patient-to-Professional / Coronavirus Infections / Neurosurgical Procedures / Betacoronavirus Type of study: Clinical Practice Guide Limits: Humans Language: English Journal: J Neurointerv Surg Year: 2020 Document Type: Article Affiliation country: Neurintsurg-2020-016161