(1/5) THREAD. Important to share experiences with #COVID19Surgery. A few (6) more thoughts on emergency gen surgeries in suspected #COVID19 patients. See previous thread for overarching themes; surg guides soon to come. @DrJohnScott @AnnalsofSurgery @BehindTheKnife for more.
(2/5) 1. SET UP AN ANTE ROOM. If possible, isolate space from other traffic for equipment, donning/doffing, OR runner, & bed. Really helps w staff anxiety, flow of other cases, & doffing.
2. PLAN FOR BED. Contaminated bed linen bagged in OR & wiped bed sent to ante room.
2. PLAN FOR BED. Contaminated bed linen bagged in OR & wiped bed sent to ante room.
(3/5) 3. PAGERS & CHARTS STAY OUTSIDE. No surface is considered clean in OR, so uncovered objects need to stay out of OR. Consider resident coverage.
4. SURGEON GOWNING. Circulator who ties surgeon gowns needs to change/remove outer contaminated gloves before tying.
4. SURGEON GOWNING. Circulator who ties surgeon gowns needs to change/remove outer contaminated gloves before tying.
(4/5) 5. SAME GOWNS. Use of disposable gowns in OR reduces doffing steps. Different doffing videos for disposable & non-disposable gowns so all OR team should use same gowns. Time where staff are most likely to contaminate themselves so team standardization helps.
(5/5) 6. MORE ON PPE. Controversy about N95 or not for surgical procedures. Multiple international references suggest N95 for surgical fluids/aerosols exposure. W extreme shortages, CDC recs N95 with face mask to reduce splash and ? allow N95 reuse. (cdc.gov/coronavirus/20…)
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