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《COVID-19 时代神经外科的准备和指南:一家三级转诊医院的印度视角》。

Preparedness and guidelines for neurosurgery in the COVID-19 era: Indian perspective from a tertiary care referral hospital.

机构信息

Departments of1Neurosurgery and.

2Microbiology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Neurosurg Focus. 2020 Dec;49(6):E3. doi: 10.3171/2020.9.FOCUS20564.

Abstract

The COVID-19 pandemic has severely impacted healthcare systems globally. The need of the hour is the development of effective strategies for protecting the lives of healthcare providers (HCPs) and judicious triage for optimal utilization of human and hospital resources. During this pandemic, neurosurgery, like other specialties, must transform, innovate, and adopt new guidelines and safety protocols for reducing the risk of cross-infection of HCPs without compromising patient care. In this article, the authors discuss the current neurosurgical practice guidelines at a high-volume tertiary care referral hospital in India and compare them with international guidelines and global consensus for neurosurgery practice in the COVID-19 era. Additionally, the authors highlight some of the modifications incorporated into their clinical practice, including those for stratification of neurosurgical cases, patient triaging based on COVID-19 testing, optimal manpower management, infrastructure reorganization, evolving modules for resident training, and innovations in operating guidelines. The authors recommend the use of their blueprint for stratification of neurosurgical cases, including their protocol for algorithmic patient triage and management and their template for manpower allocation to COVID-19 duty, as a replicable model for efficient healthcare delivery.

摘要

COVID-19 大流行已严重影响全球的医疗保健系统。当务之急是制定有效的策略来保护医疗保健提供者(HCPs)的生命,并进行明智的分诊,以最佳利用人力资源和医院资源。在这场大流行中,神经外科与其他专业一样,必须进行变革、创新,并采用新的指南和安全规程,以降低 HCPs 交叉感染的风险,同时又不影响患者的护理。在本文中,作者讨论了印度一家高容量三级转诊医院的当前神经外科实践指南,并将其与 COVID-19 时代的国际指南和全球神经外科实践共识进行了比较。此外,作者还强调了他们临床实践中采用的一些修改措施,包括对神经外科病例进行分层、根据 COVID-19 检测对患者进行分诊、最佳人力管理、基础设施重组、住院医师培训的不断发展模块以及手术指南的创新。作者建议使用他们的神经外科病例分层蓝图,包括他们的算法患者分诊和管理方案以及 COVID-19 值班人力分配模板,作为高效医疗服务的可复制模式。

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