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DOI: 10.1055/s-0041-1731293
Surgical Perspectives for Pediatric Theater Teams during the SARS-CoV-2 Pandemic and Beyond: Narrative Review and Mandatory Tasks Guidelines
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Abstract
This is a narrative review during the ongoing coronavirus disease 2019 (COVID-19) pandemic to streamline workflow of pediatric surgical patients in operating theaters and for theater teams involved in their management. Pediatric patient anxiety in theaters, aspects of communication, and optimizing vision during surgery during the pandemic have also been addressed. The COVID-19 pandemic has led to the creation of pathways in the surgical management of patients. As the pandemic progressed, hospitals developed pathways to offer increased protection to staff during procedures. This narrative review provides a clear perspective in the management of pediatric patients in operating theaters. Guidelines received from National Health Authorities and Societies affiliated with surgery, endoscopic surgery, anesthesiology, and endoscopy were carefully reviewed regarding their recommendations and data emerging from reports on COVID-19 were selected to compile the pathways specific for pediatric patients and staff. The workflow pathways have been successfully implemented during the pandemic and include a section on patients for endoscopy as well as approach to endoscopic surgery and open procedures. Theater room ergonomics that were successful during the pandemic have been outlined along with identification of areas specific to the pediatric patient anxiety, interteam communication/identification, and visor-related vision. The guidelines used successfully during the pandemic for pediatric theater teams can be used or adapted for formulating local hospital guidelines in other centers that could be valuable in patient management beyond the pandemic.
Publication History
Received: 23 April 2021
Accepted: 10 May 2021
Article published online:
20 June 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
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References
- 1 National Health Commission of the People's Republic of China. Diagnosis and treatment project for pneumonia caused by novel coronavirus infection. Trial version 5. 2020; Accessed May 28, 2021 at: http://www.gov.cn/zhengce/zhengceku/2020-02/05/5474791/files de44557832ad4be1929091dcbcfca891.pdf
- 2 Huang C, Wang Y, Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395 (10223): 497-506
- 3 Chen N, Zhou M, Dong X. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395 (10223): 507-513
- 4 Cheung KS, Hung IFN, Chan PPY. et al. Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from the Hong Kong cohort and systematic review and meta-analysis. Gastroenterology 2020; 159 (01) 81-95
- 5 FACS. org (Internet). COVID-19 Guidelines for Triage of Pediatric Patients. (Published 24 March 2020). Accessed May 28, 2021 at: https://www.facs.org/covid-19/clinical-guidance/elective-case/pediatric-surgery?fbclid=IwAR28d_VDVKDqGU7yUpW60OO3eg9nd5NJjeH6U5tFy0JJjXCAyf5icjirsIo
- 6 Updated Intercollegiate General Surgery Guidance on COVID-19 30th May 2020. Accessed May 28, 2021 at: https://www.rcseng.ac.uk/coronavirus/joint-guidance-for-surgeons-v2/7
- 7 GOV.uk (Internet). Recommended PPE for healthcare workers by secondary care inpatient clinical setting, NHS and independent sector. (V1 Published 14 May 2020, accessed 23 May 2020). Accessed May 28, 2021 at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/886707/T1_poster_Recommended_PPE_for_healthcare_workers_by_secondary_care_clinical_context.pdf
- 8 Dong Y, Mo X, Hu Y. et al. Epidemiology of Covid-19 among children in China. Pediatrics 2020; 145 (06) e20200702
- 9 Hindson J. COVID-19: faecal-oral transmission?. Nat Rev Gastroenterol Hepatol 2020; 17 (05) 259
- 10 Xu Y, Li X, Zhu B. et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med 2020; 26 (04) 502-505
- 11 Ti LK, Ang LS, Foong TW, Ng BSW. What we do when a COVID-19 patient needs an operation: operating room preparation and guidance. Can J Anaesth 2020; 67 (06) 756-758
- 12 Walsh CM, Fishman DS, Lerner DG. NASPGHAN Endoscopy and Procedures Committee. Pediatric endoscopy in the era of coronavirus disease 2019: a North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper. J Pediatr Gastroenterol Nutr 2020; 70 (06) 741-750
- 13 Al-Benna S. Infection control in operating theatres. J Perioper Pract 2012; 22 (10) 318-322
- 14 Public Health England. COVID-19: Guidance for infection prevention and control in healthcare settings. Version 1.1. 27 /03/20. COVID-19: infection prevention and control guidance. 2020 Accessed May 28, 2021 at: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control
- 15 Cook TM, Harrop-Griffiths W. Aerosol clearance times to better communicate safety after aerosol-generating procedures. Anaesthesia 2020; 75 (08) 1122-1123
- 16 Porter J, Blau E, Gharagozloo F. et al. Society of Robotic Surgery review: recommendations regarding the risk of COVID-19 transmission during minimally invasive surgery. BJU Int 2020; 126 (02) 225-234
- 17 SAGES and EAES Recommendations Regarding Surgical Response to COVID-19 Crisis. Available at: https://www.sages.org/recommendations-surgical-response-covid-19/?fbcli%20d%C2%BC%20IwAR2M139pV3bwWp9XYB%202cfWyYgrnx%20bks0W%203GZ_%20sZ0GrGXVucZQULX%20qOf7Jfk
- 18 Intercollegiate General Surgery Guidance on COVID-19 UPDATE | The Royal College of Surgeons of Edinburgh. Accessed May 28, 2021 at: https://www.rcsed.ac.uk/news-public-affairs/news/2020/march/intercollegiate-general-surgery-guidance-on-covid-19-update
- 19 Saxena AK. SARS-CoV-2 pandemic and pediatric endoscopic surgery. J Ped Endosc Surg. 2020; 2: 51-53
- 20 Kwak HD, Kim SH, Seo YS, Song KJ. Detecting hepatitis B virus in surgical smoke emitted during laparoscopic surgery. Occup Environ Med 2016; 73 (12) 857-863
- 21 Zheng MH, Boni L, Fingerhut A. Minimally invasive surgery and the novel coronavirus outbreak: lessons learned in China and Italy. Ann Surg 2020; 272 (01) e5-e6
- 22 Saxena AK. Pediatric endoscopic surgery during the ongoing SARS-CoV-2 pandemic. J Ped Endosc Surg; 2021.
- 23 Royal College of Surgeons. Intercollegiate General Surgery Guidance on COVID-19. Available at: https://www.rcsed.ac.uk/news-public-affairs/news/2020/march/intercollegiate-general-surgery-guidance-on-covid-19-update
- 24 van Doremalen N, Bushmaker T, Morris DH. et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020; 382 (16) 1564-1567
- 25 Alqadi GO, Saxena AK. Smoke and particulate filters in endoscopic surgery reviewed during the SARS-CoV-2. J Ped Endosc Surg. 2020; 2: 61-67
- 26 da Costa KM, Saxena AK. Coronavirus disease 2019 pandemic and identifying insufflators with desufflation mode and surgical smoke evacuators for safe CO2 removal. Asian J Endosc Surg 2020;
- 27 Abdelbaset AA, Saxena AK. Gasless laparoscopy revisited during the SARS-CoV-2. J Ped Endosc Surg 2020; 2: 61-67
- 28 Fronk E, Billick SB. Pre-operative anxiety in pediatric surgery patients: multiple case study analysis with literature review. Psychiatr Q 2020; 91 (04) 1439-1451