Perioperative management strategy of severe traumatic brain injury during the outbreak of COVID-19

Coronavirus Disease-19

“… 17 After completion of laryngoscopy, room sanitization with an Environmental Protection Agency–registered, hospital-grade disinfectant is recommended, with a 2% to 3% hydrogen peroxide solution, 2-g/L to 5-g/L chlorine disinfectant, or 75% alcohol. 19 According to the Centers for Disease Control and Prevention (CDC) Web site, it is unknown how long the air inside a particular examination room remains infectious and likely relates to the room size, rapidity of air exchange, patient factors (like viral shedding), amount of coughing/sneezing, and length of time a patient was in the room. 20 The CDC suggests that rooms with 50 air changes per hour (ACHs) take approximately 6 minutes and 8 minutes to purify the air with 99% and 99.9% efficiency, respectively.…”

Algorithm of traumatic brain injury management at Indonesia in the COVID 19 pandemic ERA. Retrospective cohort study

“…The first thing to note is the security of the medical staff who will handle patients in the emergency room. The use of PPE level III is a necessity in several neurosurgery centers, especially with high COVID-19 case rates [ 6 , 8 ]. However, some centers and guidelines allow the use of PPE level II [ 6 ].…”

“…Next up is screening for COVID-19 patients who enter the emergency room. There are many guidelines that explain screening methods in neurosurgery patients in general, as well as neurotrauma in particular [ 6 , 9 ]. But here, we proposed our own scoring and screening algorithm that has been developed based on conditions in Indonesia ( Table 1 and Fig.…”

“…Special transfer paths should be applied for patients with suspected or confirmed cases to avoid contamination. A minimum PPE level 2 is recommended in this condition [ 6 , 8 ].…”

“…In this pandemic condition, the number of TBI cases has indeed decreased significantly [ 6 ]. But after the start of new normal in Indonesia, traffic flow began to return to normal and increase the number of TBI cases in the neurosurgery centers.…”