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Vascular Surgery Practice Guidelines during COVID-19 Pandemic in a Setting of High Work Volume Against Limited Resources: Perspective of a Developing Country.
Bashar, Abul Hasan Muhammad; Hakim, Md Enamul; Rahman, Md Mokhlesur; Dey, Nirmal Kanti; Chowdhury, S M Minhajul Hasan; Islam, Md Moynul; Jamil, Md Saffait; Rahman, Md Mushfiqur; Islam, Md Faridul; Mandal, Naresh Chandra.
  • Bashar AHM; Department of Vascular Surgery, National Institute of Cardiovascular Diseases and Hospital, Dhaka, Bangladesh. Electronic address: ahmbashar@gmail.com.
  • Hakim ME; Department of Vascular Surgery, National Institute of Traumatology and Orthopedic Rehabilitation, Dhaka, Bangladesh.
  • Rahman MM; Department of Vascular Surgery, National Institute of Cardiovascular Diseases and Hospital, Dhaka, Bangladesh.
  • Dey NK; Department of Vascular Surgery, National Institute of Cardiovascular Diseases and Hospital, Dhaka, Bangladesh.
  • Chowdhury SMMH; Department of Vascular Surgery, National Institute of Cardiovascular Diseases and Hospital, Dhaka, Bangladesh.
  • Islam MM; Department of Vascular Surgery, National Institute of Cardiovascular Diseases and Hospital, Dhaka, Bangladesh.
  • Jamil MS; Department of Vascular Surgery, National Institute of Cardiovascular Diseases and Hospital, Dhaka, Bangladesh.
  • Rahman MM; Department of Vascular Surgery, National Institute of Cardiovascular Diseases and Hospital, Dhaka, Bangladesh.
  • Islam MF; Department of Vascular Surgery, National Institute of Cardiovascular Diseases and Hospital, Dhaka, Bangladesh.
  • Mandal NC; Department of Vascular Surgery, National Institute of Cardiovascular Diseases and Hospital, Dhaka, Bangladesh.
Ann Vasc Surg ; 70: 306-313, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-739733
ABSTRACT

BACKGROUND:

The situation of coronavirus disease 2019 (COVID-19) pandemic in the Indian subcontinent is worsening. In Bangladesh, rate of new infection has been on the rise despite limited testing facility. Constraint of resources in the health care sector makes the fight against COVID-19 more challenging for a developing country like Bangladesh. Vascular surgeons find themselves in a precarious situation while delivering professional services during this crisis. With the limited number of dedicated vascular surgeons in Bangladesh, it is important to safeguard these professionals without compromising emergency vascular care services in the long term. To this end, we at the National Institute of Cardiovascular Diseases and Hospital, Dhaka, have developed a working guideline for our vascular surgeons to follow during the COVID-19 pandemic. The guideline takes into account high vascular work volume against limited resources in the country.

METHODS:

A total of 307 emergency vascular patients were dealt with in the first 4 COVID-19 months (March through June 2020) according to the working guideline, and the results were compared with the 4 pre-COVID-19 months. Vascular trauma, dialysis access complications, and chronic limb-threatening ischemia formed the main bulk of the patient population. Vascular health care workers were regularly screened for COVID-19 infection.

RESULTS:

There was a 38% decrease in the number of patients in the COVID-19 period. Treatment outcome in COVID-19 months were comparable with that in the pre-COVID-19 months except that limb loss in the chronic limb-threatening ischemia patients was higher. COVID-19 infection among the vascular health care professionals was low.

CONCLUSIONS:

Vascular surgery practice guidelines customized for the high work volume and limited resources of the National Institute of Cardiovascular Diseases and Hospital, Dhaka were effective in delivering emergency care during COVID-19 pandemic, ensuring safety of the caregivers. Despite the fact that similar guidelines exist in different parts of the world, we believe that the present one is still relevant on the premises of a deepening COVID-19 crisis in a developing country like Bangladesh.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Outcome and Process Assessment, Health Care / Vascular Surgical Procedures / Practice Patterns, Physicians' / Workload / Developing Countries / Hospitals, High-Volume / Surgeons / COVID-19 Type of study: Clinical Practice Guide / Prognostic study Limits: Humans Country/Region as subject: Asia Language: English Journal: Ann Vasc Surg Journal subject: Vascular Diseases Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Outcome and Process Assessment, Health Care / Vascular Surgical Procedures / Practice Patterns, Physicians' / Workload / Developing Countries / Hospitals, High-Volume / Surgeons / COVID-19 Type of study: Clinical Practice Guide / Prognostic study Limits: Humans Country/Region as subject: Asia Language: English Journal: Ann Vasc Surg Journal subject: Vascular Diseases Year: 2021 Document Type: Article