Dataset Information

Impact of coronavirus (COVID-19) on otolaryngologic surgery: Brief commentary.

ABSTRACT:

Background

The Coronavirus disease-2019 (COVID-19) pandemic is a global health crisis and otolaryngologists are at increased occupational risk of contracting COVID-19. There are currently no uniform best-practice recommendations for otolaryngologic surgery in the setting of COVID-19.

Methods

We reviewed relevant publications and position statements regarding the management of otolaryngology patients in the setting of COVID-19. Recommendations regarding clinical practice during the severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) outbreaks were also reviewed.

Results

Enhanced personal protective equipment (N95 respirator and face shield or powered air-purifying respirator, disposable cap and gown, gloves) is required for any otolaryngology patient with unknown, suspected, or positive COVID-19 status. Elective procedures should be postponed indefinitely, and clinical practice should be limited to patients with urgent or emergent needs.

Conclusion

We summarize current best-practice recommendations for otolaryngologists to ensure safety for themselves, their clinical staff, and their patients.

SUBMITTER: Bann DV

PROVIDER: S-EPMC7262352 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Impact of coronavirus (COVID-19) on otolaryngologic surgery: Brief commentary.

Bann Darrin V DV Patel Vijay A VA Saadi Robert R Gniady John P JP Goyal Neerav N McGinn Johnathan D JD Goldenberg David D

Head & neck 20200417 6

<h4>Background</h4>The Coronavirus disease-2019 (COVID-19) pandemic is a global health crisis and otolaryngologists are at increased occupational risk of contracting COVID-19. There are currently no uniform best-practice recommendations for otolaryngologic surgery in the setting of COVID-19.<h4>Methods</h4>We reviewed relevant publications and position statements regarding the management of otolaryngology patients in the setting of COVID-19. Recommendations regarding clinical practice during the ...[more]

PMID: 32270565

Similar Datasets

Project description:ImportanceA patient's decision to undergo surgery may be fraught with uncertainty and decisional conflict. The unpredictable nature of the COVID-19 pandemic warrants further study into factors associated with patient decision-making.ObjectiveTo assess decisional conflict and patient-specific concerns for people undergoing otolaryngologic surgery during the pandemic.Design, setting, participantsThis prospective cross-sectional survey study was conducted via telephone from April 22 to August 31, 2020. English-speaking adults scheduled for surgery from a single academic surgical center were invited to participate. Individuals who were non-English speaking, lacked autonomous medical decision-making capacity, scheduled for emergent surgery, or had a communication disability were excluded. For race and ethnicity reporting, participants were classified dichotomously as White according to the Behavioral Risk Factor Surveillance System from the Centers for Disease Control and Prevention or non-White as a collective term including Black or African American, American Indian or Alaska Native, Asian, or Pacific Islander race and ethnicity.ExposuresThe SURE Questionnaire (sure of myself, understand information, risks/benefits ratio, and encouragement) was used to screen for decisional conflict, with a total score greater than or equal to 3 indicating clinically significant decisional conflict. Participants were asked to share their specific concerns about having surgery.Main outcome and measuresDecisional conflict and patient demographic data were assessed via bivariate analyses, multivariable logistic regression and conjunctive consolidation. Patient-specific concerns were qualitatively analyzed for summative themes.ResultsOf 444 patients screened for eligibility, 182 (40.9%) respondents participated. The median age was 60.5 years (interquartile range, 48-70 years). The racial and ethnic identity of the participants was classified as binary White (84% [153 of 182]) and non-White (16% [29 of 182]). The overall prevalence of decisional conflict was 19% (34 of 182). Decisional conflict was more prevalent among non-White than White participants (proportion difference 18.8%, 95% CI, 0.6%-37.0% and adjusted odds ratio 3.0; 95% CI, 1.2-7.4). Combining information from multiple variables through conjunctive consolidation, the group with the highest rate of decisional conflict was non-White patients with no college education receiving urgent surgery (odds ratio, 10.8; 95% CI, 2.6-45.0). Intraoperative and postoperative concerns were the most common themes expressed by participants. There was a clinically significant difference in the proportion of participants who screened positive for decisional conflict (30%) and expressed postoperative concerns than those who screened negative for decisional conflict (17%) (proportion difference, 13%; 95% CI, 1%-25%). Among patients reporting concerns about COVID-19, most screened positive for decisional conflict.Conclusions and relevanceResults of this cross-sectional survey study suggest that the COVID-19 pandemic was associated with decisional conflict in patients undergoing otolaryngologic surgery. Consistent discussion of risks and benefits is essential. The role of race and ethnicity in decisional conflict warrants further study.

Project description:AimThe rapid spread of the COVID-19 pandemic has created unprecedented challenges for the medical and surgical healthcare systems. With the ongoing need for urgent and emergency colorectal surgery, including surgery for colorectal cancer, several questions pertaining to operating room (OR) utilization and techniques needed to be rapidly addressed.MethodThis manuscript discusses knowledge related to the critical considerations of patient and caregiver safety relating to personal protective equipment (PPE) and the operating room environment.ResultsDuring the COVID-19 pandemic, additional personal protective equipment (PPE) may be required contingent upon local availability of COVID-19 testing and the incidence of known COVID-19 infection in the respective community. In addition to standard COVID-19 PPE precautions, a negative-pressure environment, including an OR, has been recommended, especially for the performance of aerosol-generating procedures (AGPs). Hospital spaces ranging from patient wards to ORs to endoscopy rooms have been successfully converted from standard positive-pressure to negative-pressure spaces. Another important consideration is the method of surgical access; specifically, minimally invasive surgery with pneumoperitoneum is an AGP and thus must be carefully considered. Current debate centres around whether it should be avoided in patients known to be infected with SARS-CoV-2 or whether it can be performed under precautions with safety measures in place to minimize exposure to aerosolized virus particles. Several important lessons learned from pressurized intraperitoneal aerosolized chemotherapy procedures are demonstrated to help improve our understanding and management.ConclusionThis paper evaluates the issues surrounding these challenges including the OR environment and AGPs which are germane to surgical practices around the world. Although there is no single universally agreed upon set of answers, we have presented what we think is a balanced cogent description of logical safe approaches to colorectal surgery during the COVID-19 pandemic.

Dataset Information

Impact of coronavirus (COVID-19) on otolaryngologic surgery: Brief commentary.

Background

Methods

Results

Conclusion

Publications

Impact of coronavirus (COVID-19) on otolaryngologic surgery: Brief commentary.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets