Recommendations for sedation outside the operating room during the COVID-19 pandemic
Abstract
The current spread of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) and its disease COVID-19, has confronted society with a paradigm shift in all fields: political, social, religious, economic, and healthcare is no exception. This has created challenges for the adequate and safe delivery of services for patients and healthcare workers.
Notwithstanding the global efforts to contain the spread of the disease, the outbreak continues to escalate. COVID-19 is currently the disease receiving the most attention worldwide; however, patients continue to present other conditions that demand the same level of care to be effectively controlled, so that they do not become another healthcare concern, as a result of potential secondary complications due to poor care.
This reflection article gives recommendations to care for patients requiring diagnostic and/or therapeutic procedures under sedation, outside the operating room, keeping the current standards and biosecurity protocols in mind. Moreover, it provides a brief description of the disease, symptoms, diagnosis and transmission routes.
References
World Health Organization (WHO). Director-General's opening remarks at the media briefing on COVID-19, 11 de marzo del 2020. Disponible en: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470-3. doi: https://doi.org/10.1016/S0140-6736(20)30185-9.
Hui DS, Azhar E, Madani T, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health. The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020;91:264-6. doi: https://doi.org/10.1016/j.ijid.2020.01.009
Xinhua. China's CDC detects a large number of new coronaviruses in the South China seafood market in Wuhan [internet]. 2020. Disponible en: https://www.xinhuanet.com/2020-01/27/c_1125504355.htm.
World Health Organization (WHO). Coronavirus disease (COVID-19) outbreak: rights, roles and responsibilities of health workers, including key considerations for occupational safety and health: interim guidance [internet]. 19 de marzo de 2020. Disponible en: https://apps.who.int/iris/handle/10665/331510.
Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507-13. doi: https://doi.org/10.1016/S0140-6736(20)30211-7.
Xian P, Xin X, Yuqing L, et al. Transmission routes of 2019nCoV and controls in dental practice. Int J Oral Sci. 2020;12:9. doi: https://doi.org/10.1038/s41368-020-0075-9.
Argentina.gob.ar. Identificación y seguimiento de contactos. [internet]. S. f. Disponible en: https://www.argentina.gob.ar/salud/coronavirus-COVID-19/Identificacion-y-seguimiento-de-contactos.
Scott F, Michelle S. COVID-19 and the problem with dental aerosols Dentistry is classified in the very-high-risk category of occupations involved with aerosol production. What does this have to do with COVID-19? Quite a lot. Here is the latest Research [internet]. 7 de abril de 2020. Disponible en: https://www.perioimplantadvisory.com/periodontics/oral-medicine-anesthetics-and-oral-systemic-connection/article/14173521/covid19-and-the-problem-with-dental-aerosols.
Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One. 2012;7(4):e35797-e. doi:
https://doi.org/10.1371/journal.pone.0035797.
Singhal T. A review of coronavirus disease-2019 (COVID-19). Indian J Pediatr. 2020;87(4):281-6. doi: https://doi.org/10.1007/s12098-020-03263-6.
Young BE, Ong SWX, Kalimuddin S, et al. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA. 2020;323(15):1488–1494. doi: https://doi.org/10.1001/jama.2020.3204.
Wujtewicz M, Dylczyk-Sommer A, Aszkiełowicz A, et al. COVID-19 - what should anaethesiologists and intensivists know about it? Anaesthesiol Intensive Ther. 2020;52(1):34-41. doi: https://doi.org/10.5114/ait.2020.93756.
Van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and surface stability of SARS-CoV- 2 as compared with SARS-CoV-1. N Engl J Med. 2020 [publicado en línea antes de impresión]. 10.1056/NEJMc2004973. doi:
https://doi.org/10.1101/2020.03.09.20033217.
Kakodkar P, Kaka N, Baig M. A comprehensive literature review on the clinical presentation, and management of the pandemic coronavirus disease 2019 (COVID-19). Cureus. 2020;12(4):e7560. doi:
https://doi.org/10.7759/cureus.7560.
Coronavirus Outbreak [internet]. 23 de febrero de 2020. Disponible en: https://www.worldometers.info/coronavirus/
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):947-506. doi: https://doi.org/10.1016/S0140-6736(20)30183-5.
González A, Escudero P, Peñasco Y, et al. Cuidados intensivos durante la epidemia coronavirus 2019. Medicina Intensiva. 2020;44(6):351-62. doi: https://doi.org/10.1016/j.medin.2020.03.001.
Ridenhour B, Kowalik J, Shay D. El número reproductivo básico (R0): consideraciones para su aplicación en la salud pública. Rev Panam Salud Publica. 2015;38(2):167-76.
Walensky RP, Del Río C. From mitigation to containment of the COVID-19 pandemic: Putting the SARS-CoV-2 genie back in the bottle. JAMA. 2020 [publicado en línea antes de impresión]. doi: https://doi.org/10.1001/jama.2020.6572.
Saavedra Trujillo CH. Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimiento de atención de la salud. Recomendaciones basadas en consenso de expertos e informadas en la evidencia. Infectio. 2020;24(3,S2);1-120. doi: https://doi.org/10.22354/in.v24i3.851.
World Health Organization (WHO). Laboratory testing for coronavirus disease 2019 (COVID-19) in suspected human cases: interim guidance [internet]. 2 de marzo de 2020. Disponible en: https://apps.who.int/iris/handle/10665/331329.
Chang D, Mo G, Yuan X, Tao Y, Peng X, Wang F-S, et al. Time kinetics of viral clearance and resolution of symptoms in novel coronavirus infection. Am J Respirat Crit Care Med. 2020;201:1150-2. doi: https://doi.org/10.1164/rccm.202003-0524LE.
Li Z, Yi Y, Luo X, Xiong N, Liu Y, Li S, et al. Development and clinical application of a rapid IgM‐IgG combined antibody test for SARS‐CoV‐2 infection diagnosis. J Med Virol. 2020;92:1518–24. doi: https://doi.org/10.1002/jmv.25727.
Guo L, Ren L, Yang S, Xiao M, Chang, Yang F, et al. Profiling early humoral response to diagnose novel coronavirus disease (COVID-19). Clin Infect Dis. 2020;71(15):778–85. doi: https://doi.org/10.1093/cid/ciaa310.
Calabrese G. Actualización de los riesgos biológicos para anestesiólogos en la atención de pacientes afectados por SARS-CoV-2, COVID-19. Anesthesiology. 2020;48(3):138-44. doi: https://doi.org/10.1097/CJ9.0000000000000173
Trujillo CHS. Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimiento de atención de la salud. Recomendaciones basadas en consenso de expertos e informadas en la evidencia. Infectio. 2020; 24 (3): 1-102. doi: https://doi.org/10.22354/in.v24i3.851.
Meselson M. Droplets and aerosols in the transmission of SARS-CoV-2. N Engl JMed. 2020;382:2063. doi: https://doi.org/10.1056/NEJMc2009324.
Gan WH, Wah J, Koh D. Preventing intra-hospital infection and transmission of coronavirus disease 2019 in healthcare workers, safety and health at work. 2020;11(2):241-3. doi: https://doi.org/10.1016/j.shaw.2020.03.001.
Organización Panamericana de la Salud (OPS). Pasos para quitarse el equipo de protección personal (EPP), incluido el overol [internet]. S.f. Disponible en: https://www.paho.org/hq/dmdocuments/2015/Equipo-de-proteccion-personal-2015-4-A3-ESP.pdf.
Government of Canada. Infection prevention and control for novel coronavirus (2019-nCoV): interim guidance for acute healthcare settings [internet]. 2020. Disponible en: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/infection-prevention-control-covid-19-second-interim-guidance.html
Kah Ti L, Ang LS, Foong TW, Wei Ng BS. What we do when a COVID-19 patient needs an operation: operating room preparation and guidance. Can J Anesth. 2020;67:756-8. doi: https://doi.org/10.1007/s12630-020-01617-4.
Sociedad Española de Anestesiología y Reanimación (SEDAR). Manejo de la vía Aérea en paciente con COVID-19 [internet]. Disponible en: https://anestesiar.org/WP/uploads/2020/03/Manejo-v%C3%ADa-a%C3%A9rea-paciente-con-coronavirus-SEDAR.pdf
Asociación Colombiana de Medicina Crítica y Cuidado Intensivo (AMCI). Declaración de consenso en medicina critica para la atención multidisciplinaria del paciente con sospecha o confirmación diagnóstica de COVID-19 [internet]. 30 de marzo de 2020. Disponible en: https://www.amci.org.co/consenso-covid19.
Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anesth/J Can Anesth. 2020;67:568-76. doi: https://doi.org/10.1007/s12630-020-01591-x.
Dexter F, Parra M, Brown J, Loftus R. Perioperative COVID-19 defense: An evidence-based approach for optimization of infection control and operating room management. Anesthesia & Analgesia J [publicación antes de impresión]. doi: 10.1213/ANE.0000000000004829.
CADTH. Aerosol-generating procedures and risk of transmission of acute respiratory infections: a systematic review. (CADTH Health technology assessment) [internet]. Ottawa (ON); 2013. Disponible en: https://www.cadth.ca/aerosol-generating-procedures-and-risk-of-transmissionacute-respiratory-infections-systematic-review.
Ministerio de Salud y Protección Social. Lineamientos para Prevención, Control y Reporte de Accidente Laboral por Exposición Ocupacional al SARS CoV-2 (COVID-19) en Instituciones de Salud. Gestión de la protección social en salud. Bogotá; 2020.
Sociedad Colombiana de Anestesiología y Reanimación (SCARE). Recomendaciones para el personal de salud en el Contexto de fase de mitigación por SARS COV-2 durante procedimientos quirúrgicos y diagnósticos [internet]. 2020. Disponible en: https://www.comunidadacademicascare.com/394-recomendaciones-para-el-personal-de-salud-en-elcontexto-de-fase-de-mitigación-por-sars-cov-2durante-procedimientos-quirúrgicos-y-diagnósticos.html.
Ministerio de Salud y Protección Social. Colombia entra en fase de mitigación de la COVID-19 [internet]. 31 de marzo de 2020. Disponible en: https://www.minsalud.gov.co/Paginas/Colombia-entra-en-fase-de-mitigacion-de-la-COVID-19.aspx.
Ministerio de Salud y Protección Social. En La fase de mitigación lo que cambia para la ciudadanía es que tenemos circulación local del coronavirus: Carlos Álvarez [internet]. 1 de abril de 2020. Disponible en: https://www.minsalud.gov.co/Paginas/En-La-fase-de-mitigacion--lo-que-cambia-para-la-ciudadania-es--que-tenemos-circulacion-local-del-coronavirus-Carlos-Alvarez.aspx.
Ge Z yu, Yang L ming, Xia J jia, Fu X hui, Zhang Y zhen. Possible aerosol transmission of COVID-19 and special precautions in dentistry. J Zhejiang University: Science B. 2020;21:361-8. doi: https://doi.org/10.1631/jzus.B2010010
Downloads
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
