Consensus document of the Interventional Cardiology and Heart Rhythm Associations of the Spanish Society of Cardiology on the management of invasive cardiac procedure rooms during the COVID-19 coronavirus outbreak

Abstract

Questo protocollo ha l'obiettivo di fornire una guida per la gestione delle sale di Emodinamica e del personale ad esse afferente, che consenta di garantire idonei livelli di trattamento ed al contempo l'applicazione di tutte le misure di prevenzione e controllo delle infezioni durante la gestione dei casi SOSPETTI, PROBABILI o CONFERMATI di infezione da virus 2019-nCoV NON DIFFERIBILI (per i quali il trattamento interventistico non può attendere il risultato del tampone che dovrà comunque essere processato con priorità). Si intende per caso SOSPETTO il paziente che: A) Presenta uno o più dei seguenti sintomi: febbre o tosse o difficoltà respiratoria Associato a B) Contatto stretto* di un caso confermato di COVID-19 oppure essere stato in zone con presunta trasmissione comunitaria diffusa o locale. Si intende per caso PROBABILE il paziente che: presenti caratteristiche di SOSPETTO + risultato test dubbio o inconcludente.Per caso CONFERMATO si intende paziente con conferma di laboratorio indipendentemente dalla presenza di segni e sintomi clinici.*Definizione di contatto stretto (il collegamento epidemiologico può essere avvenuto entro un periodo di 14 giorni prima dell'insorgenza della malattia):

Electrotherapy and electrophysiology procedures during the coronavirus disease 2019 pandemic: an opinion of the Heart Rhythm Section of the Polish Cardiac Society (with an update)

“…9 7 Activities such as placement of the electrodes or administration of the intravenous drip should be performed before entering the operating theatre in order to limit the scope of activities in the operating room to an absolute minimum. 8 Disinfection of the surgical site: tinted solution of alcohol intended for the disinfection of the surgical site; perioperative antibiotic therapy: according to the existing guidelines. 9 The pacemaker check as well as programming and entering data should take place in the operating room.…”

“…During the epidemic, it seems justifiable to postpone elective procedures such as: implantation of pacemakers in case of mildly symptomatic bradycardia, upgrading of the pacing systems, placement of ICDs in the primary prevention of sudden cardiac death, ablations of supraventricular arrhythmias and benign ventricular arrhythmias relatively well -tolerated by the patient which do not require immediate hospitalization. The aim behind this is to protect the patients from the contact with healthcare personnel, which may pose a potential threat of infection 8. The procedures with emergency indications should be performed with accordance to the previous protocols (FIGURE 1).…”

EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes during the COVID-19 pandemic

“…A daily checklist for the presence of adequate PPE in the cathlab and for a dedicated crash cart (Figure 4; Supplementary material, Table S4) should be completed. 47,48 Donning and doffing procedures All HCWs have to be routinely trained in the correct and appropriate use of PPE. Donning/doffing (the process of putting on and removing PPE) manoeuvres should be supervised by a trained observer who reads the correct sequence of PPE use to minimize the risk of contamination ( Table 3).…”

ST-segment elevation myocardial infarction in times of COVID-19: back to the last century? A call for attention

“…4 On the one hand, people are reluctant to attend hospital despite warning symptoms and, on the other hand, the emergency system is markedly overloaded, leading to a delay in both the diagnosis and treatment of STEMI patients. 4 Despite the lack of solid evidence, various protocols have been published by scientific societies, 5,6 which aim to ensure adequate treatment of the patient with STEMI in this context, with special emphasis also on protection against infection of the health personnel involved.…”