Arora Vivek, Evans Connie, Langdale Lorrie, Lee Alex
is an Anesthesiologist and Surgical Intensivist, is an Operating Room Registered Nurse Educator, is a Surgical Intensivist and Chief of General Surgery, and is an Anesthesiologist and Surgical Intensivist, all at VA Puget Sound Health Care System in Seattle, Washington. Vivek Arora and Alex Lee are affiliated with the Department of Anesthesiology and Pain Medicine and Lorrie Langdale is affiliated with the Department of Surgery, University of Washington in Seattle.
Fed Pract. 2020 May;37(5):212-218.
The worldwide spread of SARS-CoV-2, the coronavirus that causes the syndrome designated COVID-19, presents a challenge for emergency operative management. The transmission and virulence of this new pathogen has raised concern for how best to protect operating room staff while effectively providing care to the infected patient requiring urgent or emergent surgery.
Establishment of a clear protocol that adheres to rigorous infection control measures while providing a safe system for interfacility transport and operative care is vital to a successful surgical pandemic response. While emergency protocols must be rapidly developed, they should be collaboratively improved and incorporate new knowledge as and when it becomes available. These measures combined with practice drills to keep operating room personnel ready and able should help construct processes that are useful, easy to follow, and tailored to the unique local environment of each health care setting.
After the initial apprehensions and struggles during our confrontation with the COVID-19 crisis, it is our hope that the experience we share will be helpful to surgical staff at other institutions grappling with the challenges of operative care in the pandemic environment. While this protocol focuses on the current COVID-19 pandemic, these recommendations serve as a template for surgical preparedness that can be readily adapted to infectious disease crisis that unfortunately might emerge in the future.
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在全球范围内传播,该冠状病毒可导致名为2019冠状病毒病(COVID-19)的综合征,这给紧急手术管理带来了挑战。这种新病原体的传播和毒力引发了人们对于如何在有效为需要紧急或急诊手术的感染患者提供治疗的同时,最好地保护手术室工作人员的担忧。
制定明确的方案,既要坚持严格的感染控制措施,又要为机构间转运和手术护理提供安全系统,这对于成功应对手术大流行至关重要。虽然必须迅速制定紧急方案,但应共同改进这些方案,并在有新知识时将其纳入。这些措施与实践演练相结合,以使手术室人员随时做好准备并具备相应能力,应有助于构建有用、易于遵循且适合每个医疗环境独特当地情况的流程。
在我们应对COVID-19危机期间经历了最初的担忧和挣扎之后,我们希望分享的经验将有助于其他机构的外科工作人员应对大流行环境中手术护理的挑战。虽然本方案侧重于当前的COVID-19大流行,但这些建议可作为手术准备的模板,可轻松适用于未来可能出现的不幸传染病危机。