Children's Wisconsin and Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, 999 North 92nd Street, Suite CCC 320, Milwaukee, WI, 53226, USA.
Division of Pediatric Pathology, Department of Pathology and Laboratory Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Pediatr Surg Int. 2021 Jul;37(7):871-880. doi: 10.1007/s00383-021-04878-2. Epub 2021 Mar 14.
With the emergence of the coronavirus disease-2019 (COVID-19) pandemic, institutions were tasked with developing individualized pre-procedural testing strategies that allowed for re-initiation of elective procedures within national and state guidelines. This report describes the experience of a single US children's hospital (Children's Wisconsin, CW) in developing a universal pre-procedural COVID-19 testing protocol and reports early outcomes.
The CW pre-procedural COVID-19 response began with the creation of a multi-disciplinary taskforce that sought to develop a strategy for universal pre-procedural COVID-19 testing which (1) maximized patient safety, (2) prevented in-hospital viral transmission, (3) conserved resources, and (4) allowed for resumption of procedural care within institutional capacity.
Of 11,209 general anesthetics performed at CW from March 16, 2020 to October 31, 2020, 11,150 patients (99.5%) underwent pre-procedural COVID-19 testing. Overall, 1.4% of pre-procedural patients tested positive for COVID-19. By June 2020, CW was operating at near-normal procedural volume and there were no documented cases of in-hospital viral transmission. Only 0.5% of procedures were performed under augmented COVID-19 precautions (negative pressure environment and highest-level personal protective equipment).
CW successfully developed a multi-disciplinary pre-procedural COVID-19 testing protocol that enabled resumption of near-normal procedural volume within three months while limiting in-hospital viral transmission and resource use.
随着 2019 年冠状病毒病(COVID-19)大流行的出现,各机构承担着制定个体化术前检测策略的任务,这些策略允许在国家和州指南内重新启动择期手术。本报告描述了一家美国儿童医院(威斯康星儿童医院,CW)制定通用术前 COVID-19 检测方案的经验,并报告了早期结果。
CW 的术前 COVID-19 应对始于成立一个多学科工作组,该工作组试图制定一个通用术前 COVID-19 检测策略,该策略(1)最大限度地提高患者安全性,(2)防止医院内病毒传播,(3)节约资源,以及(4)允许在机构能力范围内恢复手术护理。
2020 年 3 月 16 日至 2020 年 10 月 31 日,在 CW 进行的 11209 例全身麻醉中,有 11150 例患者(99.5%)接受了术前 COVID-19 检测。总体而言,术前患者中有 1.4%检测出 COVID-19 阳性。到 2020 年 6 月,CW 的手术量已接近正常,并且没有记录到医院内病毒传播的病例。只有 0.5%的手术在增强的 COVID-19 预防措施(负压环境和最高级别的个人防护设备)下进行。
CW 成功制定了一个多学科的术前 COVID-19 检测方案,在三个月内恢复了接近正常的手术量,同时限制了医院内的病毒传播和资源使用。