Features of the surgical care organization and medical evacuation measures in the COVID-19 pandemic conditions
Abstract
The purpose - to study the features of the organization of the provision of surgical care and the implementation of medical and evacuation measures in the context of the COVID-19 pandemic.
Materials and methods. With the help of historical, bibliographic and comparative analysis and a systematic approach, the literature data on sanitary-epidemiological and treatment-evacuation measures in the context of a pandemic of a new coronavirus infection in the Armed Forces of Ukraine were summarized.
Results. The article considers materials of modern world standards on this issue and summarizes the own experience of the Military Medical Clinical Center of the Eastern Region. Taking into account the standards and guidelines of the World Health Organization and the Center for Disease Control and Prevention, a ranked approach is proposed to determine the possibility, feasibility and safety of performing surgical interventions in the UZ of the Ministry of Defense of Ukraine. And the procedure for organizing the provision of surgical care and the implementation of medical and evacuation measures in the context of the COVID-19 pandemic was proposed. Particular attention is paid to the division of patients into categories, depending on the specific clinical situation, as well as the earliest possible separation of patient flows and the exclusion of the possibility of mixing them.
Conclusions. For the safe organization of the provision of surgical care and medical and evacuation measures in the context of the COVID-19 pandemic, it is necessary to ensure: strict control of the sanitary epidemiological regime and infection control measures; "Air insulation"; minimization of contacts; separation of streams of sick "clean" and potentially infected; clear prioritization of procedures; ranked assistance. For this, the following was introduced and should be supported: strict restriction of access of unauthorized persons to the territory of the UZ; maximum unloading of the hospital base, rarefaction of patients, graded reduction in the volume of care; strengthening control over compliance with sanitary requirements, decontamination measures and sanitary and epidemiological supervision; insurance for the performance of aerosol-generating procedures, incl. laparoscopic interventions, provision of health care personnel by personal protective equipment and control over their use; a clear algorithm for sorting and routing patients; training.
References
World Health Organisation WHO Director-General’s opening remarks at the media briefing on COVID-19. 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19-11-march-2020 accessed March 29, 2020.
Nicola, M., O'Neill, N., Sohrabi, C., Khan, M., Agha, M., Agha, R. (2020). Evidence based management guideline for the COVID-19 pandemic - review article. Int. J. Surg. Lond. Engl. https://doi.org/10.1016/j.ijsu.2020.04.001.
Nicola, M., Alsafi, Z., Sohrabi, C., Kerwan, A., Al-Jabir, A., Iosifidis, C., Agha, M., Agha, R. (2020). The socio-economic implications of the coronavirus and COVID-19 pandemic: a review. Int. J. Surg. https://doi.org/10.1016/j.ijsu.2020.04.018.
Kurihara, H., Bisagni, P., Faccincani, R., Zago, M. COVID-19 outbreak IN northern Italy: viewpoint OF the milan area surgical community. J. Trauma Acute Care Surg. 2020;1 https://doi.org/10.1097/TA.0000000000002695.
Brindle, M., Gawande, A. Managing, COVID-19 in surgical systems. Ann. Surg. 2020;1 https://doi.org/10.1097/SLA.0000000000003923.
COVIDSurg Collaborative Global guidance for surgical care during the COVID-19 pandemic: surgical care during the COVID-19 pandemic (2020). Br. J. Surg. https://doi.org/10.1002/bjs.11646.
Ferguson, N., Laydon, D., and other. (2020). Report 9: impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand.
Stevens, S. Next steps on NHS response to COVID-19. (2020). https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/urgent-next-steps-on-nhs-response-to-covid-19-letter-simon-stevens.pdf
Ziser, A., Alkobi, M., Markovits, R., Rozenberg, B. The recovery room as an intensive care unit. Crit. Care. 1998;2:P165. https://doi.org/10.1186/cc294.
Royal College of Surgeons of England Guidance for surgeons working during the COVID-19 pandemic. (2020). https://www.rcseng.ac.uk/coronavirus/joint-guidance-for-surgeons-v1/.
Schwartz, A.M., Wilson, J., Boden, S.D., Moore, T.J., Bradbury, T.L., Fletcher, N.D. (2020). Managing resident workforce and education during the COVID-19 pandemic. J. Bone Jt. Surg. https://journals.lww.com/jbjsjournal/Documents/Schwartz.pdf.
Dexter, F., Parra, M.C., Brown, J.R., Loftus, R.W. (2020). Perioperative COVID-19 defense: an evidence-based approach for optimization of infection control and operating room management. Anesth. Analg. https://doi.org/10.1213/ANE.0000000000004829.
Browne, C., Davis, N.F., Mac Craith, E.D., Lennon, G.M., Galvin, D.J., Mulvin, D.W. (2018). Prospective evaluation of a virtual urology outpatient clinic. Ir. J. Med. Sci. 187: 251–254. https://doi.org/10.1007/s11845-017-1615-y.
Sultan, A.A., Acuña, A.J., Samuel, L.T., Rabin, J.M., Grits, D., Gurd, D.P., Kuivila, T.E., Goodwin, R.C. (2020). Utilization of telemedicine virtual visits in pediatric spinal deformity patients: a comparison of feasibility and patient satisfaction at a large academic center. J. Pediatr. Orthop. https://doi.org/10.1097/BPO.0000000000001553.
Connor, M.J., Winkler, M., Miah, S. (2020). COVID-19 Pandemic - is Virtual Urology Clinic the answer to keeping the cancer pathway moving? BJU Int. https://doi.org/10.1111/bju.15061.
Greenhalgh, T., Shaw, S., and other. (2018). Real-world implementation of video outpatient consultations at macro, meso, and micro levels: mixed-method study. J. Med. Internet Res. 20. https://doi.org/10.2196/jmir.9897.
UCLPartners How-to guide: non face-to-face clinics. (2019). https://uclpartners.com/non-face-to-face-clinics-resource/.
General Medical Council How we will continue to regulate in light of novel coronavirus (Covid-19) (2020). https://www.gmc-uk.org/news/news-archive/how-we-will-continue-to-regulate-in-light-of-novel-coronavirus.
Iacobucci, G. (2020). Covid-19: all non-urgent elective surgery is suspended for at least three months in England. BMJ.: m 1106. https://doi.org/10.1136/bmj.m1106.
World Health Organisation Coronavirus disease 2019. https://www.who.int/emergencies/diseases/novel-coronavirus-2019 .
European Centre for Disease Prevention and Control (ECDC) Infection prevention and control and preparedness for COVID-19 in healthcare settings. 2020. https://www.ecdc.europa.eu/en/publications-data/infection-prevention-and-control-and-preparedness-covid-19-healthcare-settings.
World Health Organisation . Aide Memoire); Geneva: 2008. Epidemic- and Pandemic-Prone Acute Respiratory Diseases Infection Prevention and Control in Health Care. https://www.who.int/csr/resources/publications/EPR_AM3_E3.pdf.
American College of Surgeons. (2020). COVID-19: considerations for optimum surgeon protection before, during, and after operation. https://www.facs.org/covid-19/clinical-guidance/surgeon-protection
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