COVID-19: What are the challenges for NHS surgery?

Wielogórska, Natasha L.; Ekwobi, Chidi

doi:10.1016/j.cpsurg.2020.100856

Cited by 20 publications

(17 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The pandemic has also highlighted the impact that a major incident can have on apparently unrelated services. Operating theatre suites were repurposed into treatment areas for ventilated patients and commonly accepted working practices were overhauled such as donning and doffing in anaesthetics rooms and conducting anaesthesia in the same clinical space as the subsequent surgery, 13 though this is commonplace outside of the UK. During the first wave of the COVID-19 pandemic, the protracted reduction in services deemed ‘non-essential’ became both morally intolerable to the nation, and likely had consequences on many areas affecting the long-term health of several thousand non-COVID patients.…”

Section: Lessons Learned From the Covid-19 Pandemicmentioning

confidence: 99%

Training for major incidents

Porthouse¹,

Clancy²,

Lax³

2021

Surgery (Oxford)

View full text Add to dashboard Cite

Major incidents are serious events with broad-reaching consequences that require extraordinary solutions to be implemented. They call for a team-based approach and efficient communication at all levels in addition to effective command, control and oversight. While consolidation of care into major trauma centres has led to improved outcomes for patients, it also means that clinicians may miss out on real-life experience of major incident or severe trauma casualties. It is therefore important to factor training, exercises and planning into individual and organizational preparedness. While several recent major incidents have occurred and provided further experience and lessons, such as the Grenfell Fire, Manchester Arena bombings and London Bridge stabbings, the global COVID-19 pandemic has required clinicians and organizations around the world to re-examine major incidents and the extent of their impacts. This has reinforced the importance of all members of the clinical team possessing an appropriate level of awareness and understanding of major incidents.

show abstract

Section: Lessons Learned From the Covid-19 Pandemicmentioning

confidence: 99%

Training for major incidents

Porthouse¹,

Clancy²,

Lax³

2021

Surgery (Oxford)

View full text Add to dashboard Cite

show abstract

“…The lack of large-scale testing for all patients admitted for surgical pathologies is still a major challenge for many countries. Limitations in screening capacity, unsatisfactory delays to result reporting (especially in management of acute emergencies) and a high false negative rate (up to 20%), have complicated preoperative screening [61]. The filtration systems for laparoscopic smoke are not a standard for many surgical departments.…”

Section: The Impact Of the Novel Guidelines Upon Surgical Practicementioning

confidence: 99%

Laparoscopic Surgery in COVID-19 Era—Safety and Ethical Issues

et al. 2020

View full text Add to dashboard Cite

(1) Background:The paper aims to review the available evidence regarding the health risk of the aerosolization induced by laparoscopy induced and impact of the COVID-19 pandemic upon minimally invasive surgery.(2) Materials and methods: A systematic review of the literature was performed on PubMed, Medline and Scopus until July 10th. (3) Results: Chemicals, carcinogens and biologically active materials, such as bacteria and viruses, have been isolated in surgical smoke. However, the only evidence of viral transmission through surgical smoke to medical staff is post-laser ablation of HPV-positive genital warts. The reports of SARS-CoV-2 infected patients who underwent laparoscopic surgery revealed the presence of the virus, when tested, in digestive wall and stools in 50% of cases but not in bile or peritoneal fluid. All surgeries did not result in contamination of the personnel, when protective measures were applied, including personal protective equipment (PPE) and filtration of the pneumoperitoneum. There are no comparative studies between classical and laparoscopic surgery. (4) Conclusions: Previously published data showed there is a possible infectious and toxic risk related to surgical smoke but not particularly proven for SARS-CoV-2. Implementing standardized filtration systems for smoke evacuation during laparoscopy, although increases costs, is necessary to increase the safety and it will probably remain a routine also in the future.

show abstract

“…The global spread of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has disrupted and pressurized an already over‐stretched NHS. This pressure is reflected in the data with the United Kingdom (UK) performing poorly against its European neighbors on key parameters such as beds per population (2.5 per 1000) and doctors per population (3.0 per 1000) 2 which has stifled healthcare provisions for non‐COVID patients 3 . Doctors' concerns have been laid bare in a survey by the British Medical Association (BMA) 4 where thousands of doctors reported to the BMA that prioritizing care for those with coronavirus disease 19 (COVID‐19) has had a severe impact on the treatment and care available for patients with other illnesses.…”

Section: Introductionmentioning

confidence: 99%

COVID‐19: The rising cost of cardiac surgery and disease

2020

View full text Add to dashboard Cite

The coronavirus disease 19 (COVID‐19) pandemic has resulted in widespread economic, health and social disruptions. The delivery of cardiovascular care has been stifled during the pandemic to adhere to infection control measures as a way of protecting patients and the workforce at large. This cautious approach has been protective since individuals with COVID‐19 and cardiovascular disease are anticipated to have poorer outcomes and an increased risk of death. The combination of postponing elective cardiovascular surgeries, reduced acute care and long‐term cardiac damage directly resulting from COVID‐19 will likely have increased the demand for cardiac care, particularly from patients presenting with more severe symptoms. The combination of increased demand and inhibited supply will likely result in huge backlog of unmet patients' needs. The novelty, virulence and infectivity of severe acute respiratory syndrome coronavirus 2 has caused substantial morbidity and mortality, thus necessitating modifications to the UK government's healthcare strategy. Without improving cost efficiency, the UK's ageing population will likely need an increasing spend on cardiac surgery simply to maintain the same level of service. However, the government's short‐term increase in spending is unsustainable especially in the face of ongoing economic uncertainty. This means that the long‐term impact of COVID‐19 will only increase the need to find innovative ways of delivering equivalent or superior cardiac care at a reduced unit cost.

show abstract

COVID-19: What are the challenges for NHS surgery?

Cited by 20 publications

References 38 publications

Training for major incidents

Training for major incidents

Laparoscopic Surgery in COVID-19 Era—Safety and Ethical Issues

COVID‐19: The rising cost of cardiac surgery and disease

Contact Info

Product

Resources

About