Organizational aspects of pediatric anesthesia and surgery between two waves of Covid‐19

Camporesi, Anna; Melloni, Giorgio; Diotto, Veronica; Bertani, Patrizia; Pergola, Enrico La; Pelizzo, Glória

doi:10.1111/aas.13802

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Every center suffered from a dramatic reduction of ward spaces because some rooms were dedicated to surgical patients with COVID-19, operating rooms in general hospitals were used for adults and children, and some pediatric hospitals were converted to intensive care units (ICUs). Some pediatric hospitals accepted adult patients with positive COVID-19 for a period in intensive care ( 9 ).…”

Section: Resultsmentioning

confidence: 99%

Pediatric Surgical Care During the COVID-19 Lockdown: What Has Changed and Future Perspectives for Restarting in Italy. The Point of View of the Italian Society of Pediatric Surgery

et al. 2022

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Background:The coronavirus disease 2019 (COVID-19) time exacerbated some of the conditions already considered critical in pediatric health assistance before the pandemic. A new form of pediatric social abandonment has arisen leading to diagnostic delays in surgical disorders and a lack of support for the chronic ones. Health services were interrupted and ministerial appointments for pediatric surgical healthcare reprogramming were postponed. As a result, any determination to regulate the term “pediatric” specificity was lost. The aim is, while facing the critical issues exacerbated by the COVID-19 pandemic, to rebuild future perspectives of pediatric surgical care in Italy.MethodsEach Pediatric Society, including the Italian Society of Pediatric Surgery (SICP), was asked by the Italian Federation of Pediatric Associations and Scientific Societies to fill a questionnaire, including the following the main issues: evaluation of pre-pandemic criticalities, pediatric care during the pandemic and recovery, and current criticalities. The future care model of our specialty was analyzed in the second part of the questionnaire.ResultsChildren are seriously penalized both for surgical treatment as well as for the diagnostic component. In most centers, the pediatric surgical teams have been integrated with the adult ones and the specificity of training the pediatric operating nursing is in danger of survival. “Emotional” management of the child is not considered by the general management and the child has become again an adults patient of reduced size.ConclusionA new functional pediatric surgical model needs to be established in general hospitals, including activities for day surgery and outpatient surgery. To support the care of the fragile child, a national health plan for the pediatric surgery is required.

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Section: Resultsmentioning

confidence: 99%

Pediatric Surgical Care During the COVID-19 Lockdown: What Has Changed and Future Perspectives for Restarting in Italy. The Point of View of the Italian Society of Pediatric Surgery

et al. 2022

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“…As these management guidelines were developed, the hospitals were reconfigured to increase their capacity to care for COVID-19 patients. "Not necessary" surgeries were postponed, supplies and personal protective equipment were provided to the staff, drugs were investigated for the disease and/or its complications, and preoperative tests were made mandatory for COVID-19, a practice which has generated much controversy, especially in countries with limited resources [31,39]. On the other hand, asymptomatic carriers among the health personnel have been considered a risk of transmission of COVID-19, especially personnel working in emergency departments.…”

Section: Risk Of Infection and Death For The Health Personnelmentioning

confidence: 99%

Regional Anesthesia in Times of COVID-19

Whizar-Lugo¹,

Iñiguez-López²,

Castorena-Arellano³

2022

Topics in Regional Anesthesia

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The globalized coronavirus pandemic 2019 has kept us on our toes. Although confusion is widespread and there is a trend toward normalization of almost all human activities, outbreaks remain frequent. The majority of patients with COVID-19 have a trivial to moderate clinical course; a small group develops severe pneumonia and other life-threatening complications. Vaccination against this virus has contributed to better control of the pandemic, but there are no antiviral drugs that have demonstrated efficacy; therefore, the management of surgical patients confirmed or suspected of this disease is a challenge for health care workers, including the anesthesiologists, as well as the non-COVID-19 patients who at a given moment could become carriers or sick. General anesthesia produces aerosols and risks medical and technical personnel being infected, especially those who manage the airway. On the other hand, regional anesthesia has advantages over general anesthesia because the airway is not handled; however, its limited duration is the most important concern. It is reasonable that regional anesthesia occupies a preponderant place in the safe management of all patients, as long as the type of surgery allows it, the anesthesiologist has sufficient skills and patients accept the proposed technique. At this time of globalized crisis due to COVID-19, the intrapandemic anesthetic management of patients undergoing surgery continues to be a changing task, a challenge that has been solved as new data based on solid scientific evidence arise, besides the development of drugs, safer vaccines, equipment, and health prophylactic methods. There is a clear tendency to use regional anesthesia whenever this is possible.

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Organizational aspects of pediatric anesthesia and surgery between two waves of Covid‐19

Camporesi

Melloni

Diotto

et al. 2021

Acta Anaesthesiol Scand

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Background The initial wave of the Covid‐19 pandemic has hit Italy, and Lombardy in particular, with violence, forcing to reshape all hospitals' activities; this happened even in pediatric hospitals, although the young population seemed initially spared from the disease. “Vittore Buzzi” Children's Hospital, which is a pediatric/maternal hospital located in Milan (Lombardy Region), had to stop elective procedures—with the exception of urgent/emergent ones—between February and May 2020 to leave space and resources to adults' care. We describe the challenges of reshaping the hospital's identity and structure, and restarting pediatric surgery and anesthesia, from May on, in the most hit area of the world, with the purpose to avoid and contain infections. Both patients and caregivers admitted to hospital have been tested for Sars‐CoV‐2 in every case. Methods Observational cohort study via review of clinical charts of patients undergoing surgery between 16th May and 30th September 2020, together with SARS‐CoV ‐2 RT‐PCR testing outcomes, and comparison to same period surgeries in 2019. Results An increase of approximately 70% in pediatric surgeries (OR 1.68 [1.33‐2.13], P < .001) and a higher increase in the number of surgeries were reported (OR 1.75 (1.43‐2.15), P < .001). Considering only urgent procedures, a significant difference in the distribution of the type of surgery was observed (Chi‐squared P ‐value < .001). Sars‐CoV‐2‐positive patients have been 0.8% of total number; 14% of these was discovered through caregiver's positivity. Conclusion We describe our pathway for safe pediatric surgery and anesthesia and the importance of testing both patient and caregiver.

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Organizational aspects of pediatric anesthesia and surgery between two waves of Covid‐19

Cited by 3 publications

References 25 publications

Pediatric Surgical Care During the COVID-19 Lockdown: What Has Changed and Future Perspectives for Restarting in Italy. The Point of View of the Italian Society of Pediatric Surgery

Pediatric Surgical Care During the COVID-19 Lockdown: What Has Changed and Future Perspectives for Restarting in Italy. The Point of View of the Italian Society of Pediatric Surgery

Regional Anesthesia in Times of COVID-19

Organizational aspects of pediatric anesthesia and surgery between two waves of Covid‐19

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