RT Journal Article
SR Electronic
T1 Minimizing SARS-CoV-2 exposure when performing surgical interventions during the COVID-19 pandemic
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 643
OP 647
DO 10.1136/neurintsurg-2020-016161
VO 12
IS 7
A1 Aditya S Pandey
A1 Andrew J Ringer
A1 Ansaar T Rai
A1 Peter Kan
A1 Pascal Jabbour
A1 Adnan H Siddiqui
A1 Elad I Levy
A1 Kenneth V Snyder
A1 Howard Riina
A1 Omar Tanweer
A1 Michael R Levitt
A1 Louis J Kim
A1 Erol Veznedaroglu
A1 Mandy J Binning
A1 Adam S Arthur
A1 J Mocco
A1 Clemens Schirmer
A1 Byron Gregory Thompson
A1 David Langer
A1 ,
YR 2020
UL http://jnis.bmj.com/content/12/7/643.abstract
AB 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.