Reconfiguring the scope and practice of regional anesthesia in a pandemic: the COVID-19 perspective.
Reg Anesth Pain Med
; 45(7): 536-543, 2020 07.
Article
in English
| MEDLINE | ID: covidwho-419071
ABSTRACT
The COVID-19 outbreak is on the world. While many countries have imposed general lockdown, emergency services are continuing. Healthcare professionals have been infected with the virulent severe acute respiratory syndrome coronavirus-2 (SARS), which spreads by close contact and aerosols. The anesthesiologist is particularly vulnerable to aerosols while performing intubation and other airway related procedures. Regional anesthesia (RA) minimizes the need for airway manipulation and the risks of cross infection to other patients, and the healthcare personnel. In this context, for prioritizing RA over general anesthesia, wherever possible, a structured algorithmic approach is outlined. The role of percentage saturation of hemoglobin with oxygen (oxygen saturation), blood pressure and early use of point-of-care ultrasound in differential diagnosis and specific management is detailed. The perioperative anesthetic implications of multisystem manifestations of COVID-19, anesthetic management options, the scope of RA and considerations for its safe conduct in operating rooms is described. An outline for safe and rapid training of healthcare personnel, with an Entrustable Professional Activity framework for ascertaining the practice readiness among trained residents for RA in COVID-19, is suggested. These are the authors' experiences gained from the current pandemic and similar SARS, Middle East Respiratory Syndrome and influenza outbreaks in recent past faced by our authors in Singapore, India, Hong Kong and Canada.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Cross Infection
/
Coronavirus Infections
/
Pandemics
/
Clinical Decision-Making
/
Betacoronavirus
/
Anesthesia, Conduction
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Qualitative research
/
Randomized controlled trials
Limits:
Humans
Language:
English
Journal:
Reg Anesth Pain Med
Journal subject:
Anesthesiology
/
Neurology
/
Psychophysiology
Year:
2020
Document Type:
Article
Affiliation country:
Rapm-2020-101541
Similar
MEDLINE
...
LILACS
LIS