The Covid-19 Outbreak and Pediatric Neurosurgery guidelines

The latest threat to global health is the ongoing outbreak of the respiratory disease that was recently given the name Coronavirus Disease 2019 (Covid-19). Covid-19 was recognized in December 2019 [1]. It was rapidly shown to be caused by a novel coronavirus that is structurally related to the virus...

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Autores principales:	Ricardo Santos de Oliveira, Matheus Fernando Manzolli Ballestero
Formato:	article
Lenguaje:	EN
Publicado:	Brazilian Society for Pediatric Neurosurgery 2020
Materias:	pediatric neurosurgery neurosurgery covid-19 health care Pediatrics RJ1-570 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/d2acfd3562a54e5585dc06b519e10c14
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id	oai:doaj.org-article:d2acfd3562a54e5585dc06b519e10c14
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	pediatric neurosurgery neurosurgery covid-19 health care Pediatrics RJ1-570 Surgery RD1-811
spellingShingle	pediatric neurosurgery neurosurgery covid-19 health care Pediatrics RJ1-570 Surgery RD1-811 Ricardo Santos de Oliveira Matheus Fernando Manzolli Ballestero The Covid-19 Outbreak and Pediatric Neurosurgery guidelines
description	The latest threat to global health is the ongoing outbreak of the respiratory disease that was recently given the name Coronavirus Disease 2019 (Covid-19). Covid-19 was recognized in December 2019 [1]. It was rapidly shown to be caused by a novel coronavirus that is structurally related to the virus that causes severe acute respiratory syndrome (SARS). As in two preceding instances of emergence of coronavirus disease in the past 18 years [2] — SARS (2002 and 2003) and Middle East respiratory syndrome (MERS) (2012 to the present) — the Covid-19 outbreak has posed critical challenges for the public health, research, and medical communities. The Brazilian Society for Pediatric Neurosurgery (SBNPed) announced that all elective surgeries, non-essential pediatric neurosurgeries be delayed during the 2020 Novel Coronavirus (COVID-19) outbreak (figure 1). The recommendations provide a framework for hospitals and clinicians to implement immediately during the COVID-19 response, as more healthcare providers are increasingly being asked to assist with the COVID-19 response, it is critical that they consider whether non-essential surgeries and procedures can be delayed. The recommendations outline factors that should be considered for postponing elective surgeries. Those factors include patient risk factors, availability of beds, ventilators, staff and personal protective equipment (PPE), and the urgency of the procedure. This will help providers to focus on addressing more urgent cases and preserve resources needed for the COVID-19 response. The decision about proceeding with non-essential surgeries and procedures will be made at the local level by the clinician, patient, parents, hospital, and state and local health departments. To ensure planning strategies to carry out urgent/emergency operations during the pandemic. Rational: 1) to ensure an adequate treatment for patients, those with trauma, hemorrhage or severe infection, for example, who require immediate surgery; 2) to prepare and guide all the healthcare professionals on how to act, adequately protecting themselves with PPE; 3) to allow the minimum required people in the surgical room, thus preventing the risk of contamination of other individuals. In this regard, this is a mandatory perception of quality and safety initiatives not only for disasters and pandemics. Some overarching principles for all cases include the following: • Be aware that while some of the following triaging guidelines include a “Level 1” (e.g., lowest level of COVID-19 acuity) in the recommendations, one must be aware that the rates of COVID-19 are predicted to skyrocket in this year, and the overarching recommendation is to prepare for markedly increased rates when triaging elective cases at present. • Patients should receive appropriate and timely surgical care, including operative management, based on sound surgical judgment and availability of resources. • Consider nonoperative management whenever it is clinically appropriate for the patient. • Consider waiting on results of COVID-19 testing in patients who may be infected. • Avoid emergency surgical procedures at night when possible due to limited team staffing. • Aerosol generating procedures (AGPs) increase risk to the health care worker but may not be avoidable. For patients who are or may be infected, AGPs should only be performed while wearing full PPE including an N95 mask or powered, air-purifying respirator (PAPR) that has been designed for the OR. Examples of known and possible AGPs include: intubation, tracheostomy.
format	article
author	Ricardo Santos de Oliveira Matheus Fernando Manzolli Ballestero
author_facet	Ricardo Santos de Oliveira Matheus Fernando Manzolli Ballestero
author_sort	Ricardo Santos de Oliveira
title	The Covid-19 Outbreak and Pediatric Neurosurgery guidelines
title_short	The Covid-19 Outbreak and Pediatric Neurosurgery guidelines
title_full	The Covid-19 Outbreak and Pediatric Neurosurgery guidelines
title_fullStr	The Covid-19 Outbreak and Pediatric Neurosurgery guidelines
title_full_unstemmed	The Covid-19 Outbreak and Pediatric Neurosurgery guidelines
title_sort	covid-19 outbreak and pediatric neurosurgery guidelines
publisher	Brazilian Society for Pediatric Neurosurgery
publishDate	2020
url	https://doaj.org/article/d2acfd3562a54e5585dc06b519e10c14
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spelling	oai:doaj.org-article:d2acfd3562a54e5585dc06b519e10c142021-11-23T21:46:36ZThe Covid-19 Outbreak and Pediatric Neurosurgery guidelines2675-362610.29327/apn.v2i1(January-April).26https://doaj.org/article/d2acfd3562a54e5585dc06b519e10c142020-04-01T00:00:00Zhttps://www.archpedneurosurg.com.br/pkp/index.php/sbnped2019/article/view/26https://doaj.org/toc/2675-3626The latest threat to global health is the ongoing outbreak of the respiratory disease that was recently given the name Coronavirus Disease 2019 (Covid-19). Covid-19 was recognized in December 2019 [1]. It was rapidly shown to be caused by a novel coronavirus that is structurally related to the virus that causes severe acute respiratory syndrome (SARS). As in two preceding instances of emergence of coronavirus disease in the past 18 years [2] — SARS (2002 and 2003) and Middle East respiratory syndrome (MERS) (2012 to the present) — the Covid-19 outbreak has posed critical challenges for the public health, research, and medical communities. The Brazilian Society for Pediatric Neurosurgery (SBNPed) announced that all elective surgeries, non-essential pediatric neurosurgeries be delayed during the 2020 Novel Coronavirus (COVID-19) outbreak (figure 1). The recommendations provide a framework for hospitals and clinicians to implement immediately during the COVID-19 response, as more healthcare providers are increasingly being asked to assist with the COVID-19 response, it is critical that they consider whether non-essential surgeries and procedures can be delayed. The recommendations outline factors that should be considered for postponing elective surgeries. Those factors include patient risk factors, availability of beds, ventilators, staff and personal protective equipment (PPE), and the urgency of the procedure. This will help providers to focus on addressing more urgent cases and preserve resources needed for the COVID-19 response. The decision about proceeding with non-essential surgeries and procedures will be made at the local level by the clinician, patient, parents, hospital, and state and local health departments. To ensure planning strategies to carry out urgent/emergency operations during the pandemic. Rational: 1) to ensure an adequate treatment for patients, those with trauma, hemorrhage or severe infection, for example, who require immediate surgery; 2) to prepare and guide all the healthcare professionals on how to act, adequately protecting themselves with PPE; 3) to allow the minimum required people in the surgical room, thus preventing the risk of contamination of other individuals. In this regard, this is a mandatory perception of quality and safety initiatives not only for disasters and pandemics. Some overarching principles for all cases include the following: • Be aware that while some of the following triaging guidelines include a “Level 1” (e.g., lowest level of COVID-19 acuity) in the recommendations, one must be aware that the rates of COVID-19 are predicted to skyrocket in this year, and the overarching recommendation is to prepare for markedly increased rates when triaging elective cases at present. • Patients should receive appropriate and timely surgical care, including operative management, based on sound surgical judgment and availability of resources. • Consider nonoperative management whenever it is clinically appropriate for the patient. • Consider waiting on results of COVID-19 testing in patients who may be infected. • Avoid emergency surgical procedures at night when possible due to limited team staffing. • Aerosol generating procedures (AGPs) increase risk to the health care worker but may not be avoidable. For patients who are or may be infected, AGPs should only be performed while wearing full PPE including an N95 mask or powered, air-purifying respirator (PAPR) that has been designed for the OR. Examples of known and possible AGPs include: intubation, tracheostomy.Ricardo Santos de OliveiraMatheus Fernando Manzolli BallesteroBrazilian Society for Pediatric Neurosurgeryarticlepediatric neurosurgeryneurosurgerycovid-19health carePediatricsRJ1-570SurgeryRD1-811ENArchives of Pediatric Neurosurgery, Vol 2, Iss 1(January-April), Pp 53-54 (2020)

The Covid-19 Outbreak and Pediatric Neurosurgery guidelines

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