TY - JOUR T1 - Minimizing SARS-CoV-2 exposure when performing surgical interventions during the COVID-19 pandemic JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 643 LP - 647 DO - 10.1136/neurintsurg-2020-016161 VL - 12 IS - 7 AU - Aditya S Pandey AU - Andrew J Ringer AU - Ansaar T Rai AU - Peter Kan AU - Pascal Jabbour AU - Adnan H Siddiqui AU - Elad I Levy AU - Kenneth V Snyder AU - Howard Riina AU - Omar Tanweer AU - Michael R Levitt AU - Louis J Kim AU - Erol Veznedaroglu AU - Mandy J Binning AU - Adam S Arthur AU - J Mocco AU - Clemens Schirmer AU - Byron Gregory Thompson AU - David Langer A2 - , Y1 - 2020/07/01 UR - http://jnis.bmj.com/content/12/7/643.abstract N2 - 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. ER -