Hassles in Resumption of Operative Treatment in Hospitals Amid COVID19
Monitoring the hassles that patients and surgeons will experience in preparation for resumption of operative treatment in hospitals amid COVID19
20May25 in one private hospital ----
"Elective surgery will resume soon. Need to have swab test negative at most 10 days prior to surgery (so negative result 10 days or less) meaning do it early since waiting period for resuIt varies."
Hassles for Patient:
1. The swab test - discomfort in the procedure; expense; etc.
2. The result - waiting for result anxiety (positive or negative); waiting time (when it will be completed).
If a swab test is done on June 1, 2020 and the negative result came out 14 days after, can a patient be operated on (ala expired clearance) [the rule is "the negative result is 10 days or less"].
If I schedule an elective operation for a patient on an outpatient basis on June 20, 2020, he / she must have a swab test on June 10, 2020 at the earliest and hope that the swab test is negative and the result is out on or before June 20, 2020.[10days]
If I schedule an elective operation for a patient on an inpatient basis on June 20, 2020, he / she must have a swab test on June 10, 2020 at the earliest and hope that the swab test is negative and the result is out on or before June 19, 2020 (he/she will be admitted the day before surgery).[9 days]
ROJ@20may25
Will continue to monitor the hassles.
PSMID-PHICS RISK ASSESSMENT OF SURGERIES IN THE CONTEXT OF COVID-19
May 26, 2020
Glad to hear these guidelines.
The question is: whether the hospitals will adopt these guidelines!
My ID classmate was saying that we are actually one step up in our local PPE practices . In RITM , WHO called them out for similar practice of “upgraded PPEs” over WHO recommendations since they were seen as the benchmark for the country. The reason was that we were still unsure about how COVID eas going to affect us.
Now that we know more and have experience for the past 3 months , we can safely modify our practices
It will also mean the improved comfort of our staff in the OR too. - Comments from a Surgeon (ES) - May 27, 2020
Some comments from the concerned surgeons:
The patients should have all the necessary information, consent and obligations including reasonable waiver!
It will be an expensive toxic set-up!
Sorry I thought we (the surgeons) should be the ones tested.
How about minor surgery like core needle biopsy of the breast? Swab test also?
According to patho, these procedures actually has more potential for contamination and they require the specimen be immediately placed on preservative and closed airtight to prevent the aerosolization.
Mas mahal pa yung swab kaysa sa procedure. He he he
And does it follow na naka level 4 protection din? or level 3 na lang kasi may RT-PCR?
I think level 3 will do. Actually once with PCR it will largely depend on the confidence of the surgeon whether to down-grade the level of protection. It is my opinion however that the assists includiing the nurses should not be prohibited if they opt to have a higher level of protection. There are so many guidelines and it onlly means one thing, no one is really sure. So, self prevention is a vitue in this uncertain time.
Level 4 protection I gathered from the OR staff adds 25-30k expense for the procedure. Include the RT-PCR and it really does get more expensive than the minor procedure itself.
We really have to rethink the use of the HAZMAT suits even for COVID patients when doing surgery. For the wards it is mandatory but for the OR, the disposable gown is already waterproof and impermeable. So it should give the correct protection already. Plus the N95 masks, double gloves, faceshield or goggles. Of course the doffing is the most important part if COVID +