key: cord-1005396-q3c0c2dp
authors: Du, Zhe; Wang, Tianbing
title: Guidelines for infection prevention and control in perioperative patients during the COVID-19 pandemic: protocol from a tertiary general hospital in Beijing
date: 2020-04-22
journal: J Minim Invasive Gynecol
DOI: 10.1016/j.jmig.2020.04.016
sha: 6f1c61bd49b7c834a0c14e5f88540d8f04dd1fa3
doc_id: 1005396
cord_uid: q3c0c2dp

nan

"Even though we're in the midst of a crisis, essential health services must continue," said Dr.

Tedros Adhanom Ghebreyesus, Director-General of WHO on Mar 30, 2020 [1] . Under the current coronavirus disease 2019 (COVID-19) pandemic situation, most Chinese hospitals are cautious in screening patients for admission. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted by not only patients with symptoms but also asymptomatic individuals [2] , which undoubtedly increases the difficulty of preventing and controlling hospital transmission. For patients requiring surgery, especially emergency patients, on the one hand, strict screening can reduce the incidence of nosocomial infection and medical staff infection, on the other hand, tedious screening may delay operation. Thus, finding a balance is the challenge. We offer the following protocol ( Figure 1 ) and recommendations for infection prevention and control in patients awaiting emergency operations.

Adopt the principle of saving people first and ensuring maximum protection [3] . We recommend CT and antibody testing as the preferred screening methods, which are faster and more effective than etiological examination. The hospital must establish a control team, which includes experts from the infection department, respiratory department, surgery department, and anesthesiology department. In case of any difficulty in decision-making, one must report to the infection control team (ICT) to confirm results. A negative pressure operating room must be established to meet the operation requirements of suspected or confirmed cases. A negative pressure isolation transfer cabin can be used by staff wearing biosafety level 3 (BSL-3) protective medical equipment to transport patients. BSL-3 protective gear, including N95 masks, goggles, protective suits, face shields, caps, shoe covers, and gloves, is required while performing operations on patients confirmed with COVID-19 or patients suspected with SARS-CoV-2 infection. For the care of patients receiving general anesthesia and endotracheal intubation, the anesthesiologist should use a powered air-purifying respirator [4] . All protective gear should be disposed off properly. The next operation must be performed 2 h after disinfection of the operation theatre (chlorine-containing detergent and ultraviolet irradiation are recommended).

In general, we believe that correct triage and mindful practice of protection measures can effectively resolve the contradiction between high operation demand and the threat of hospital infections.

WHO Director-General's opening remarks at the media briefing on COVID-19

Suggestions for infection prevention and control in digestive endoscopy during current 2019-nCoV pneumonia outbreak in Wuhan

How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People's Hospital

Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing Cesarean delivery: a case series of 17 patients

The authors declared no conflicts of interest.

This work was supported by the Beijing Natural Science Foundation (7204321).