Special considerations for the management of COVID‐19 pediatric patients in the operating room and pediatric intensive care unit in a tertiary hospital in Singapore

Thampi, Swapna; Yap, Andrea; Fan, Lijia; Ong, John

doi:10.1111/pan.13863

Cited by 22 publications

(31 citation statements)

References 12 publications

(21 reference statements)

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“…Furthermore, designated transportation routes are warranted from the ambulance bay or dedicated entrance to the OR, and from there to the isolated recovery room, PICU bed or ward. This planned itinerary should be isolated from high-traffic areas of the hospital and should not traverse the general, non-COVID-19 ORs[ 52 , 53 ].…”

Section: Specific Considerations For Pediatric Surgerymentioning

confidence: 99%

“…In areas with high COVID-19 prevalence, two separate surgical teams can be formed, one for children with COVID-19 and a second one for healthy children requiring surgery. In that instance, each team should be isolated as much as possible from the other to minimize cross-transmission and maximize operational continuity[ 53 ]. Reasonable shift implementation is also required to ensure the safety of healthcare workers and prevent burnout[ 55 ].…”

Section: Specific Considerations For Pediatric Surgerymentioning

confidence: 99%

“…Reasonable shift implementation is also required to ensure the safety of healthcare workers and prevent burnout[ 55 ]. All healthcare workers should be monitored daily prior to their shift, and are encouraged to monitor themselves throughout the day for the presence of fever or other COVID-19-related symptoms, such as cough or fatigue[ 49 , 53 ]. An organized “sick leave” policy should also be established in case a health care worker presents with symptoms suggestive of COVID-19[ 31 ].…”

Section: Specific Considerations For Pediatric Surgerymentioning

confidence: 99%

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Pediatric surgery during the COVID-19 pandemic

Dedeilia¹,

Esagian²,

Ziogas³

et al. 2020

WJCP

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The coronavirus disease 2019 (COVID-19) pandemic has had a major impact on pediatric surgery. The infection is often asymptomatic and atypical in children, while overlapping presentations with other infectious diseases generate additional diagnostic challenges. The high probability of missed pediatric cases and the invasive nature of surgery generate great concern for widespread transmission in this setting. Current guidelines suggest that triage of cases should be made on a case-by-case basis by a multidisciplinary team of experts. Decision-making can be assisted by classifying cases as elective, urgent, or an emergency according to the risks of delaying their surgical management. A workflow diagram should ideally guide the management of all cases from admission to discharge. When surgery is necessary, all staff should use appropriate personal protective equipment, and high-risk practices, such as aerosol-generating tools or procedures, should be avoided if possible. Furthermore, carefully designed organizational protocols should be established to minimize transmission while ensuring the uninterrupted operation of pediatric surgery units. For example, surgical teams can be divided into small weekly rotating groups, and healthcare workers should be continuously monitored for COVID-19 symptoms. Additionally, team protocols in the operating room can optimize communication and improve adherence to personal protective equipment use. Isolated operating rooms, pediatric intensive care units, and surgical wards should be specifically designed for suspected or confirmed COVID-19 cases. Finally, transportation of patients should be minimal and follow designated short routes. All these measures can help mitigate the effects of the COVID-19 pandemic on pediatric surgery units.

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Section: Specific Considerations For Pediatric Surgerymentioning

confidence: 99%

Section: Specific Considerations For Pediatric Surgerymentioning

confidence: 99%

Section: Specific Considerations For Pediatric Surgerymentioning

confidence: 99%

See 1 more Smart Citation

Pediatric surgery during the COVID-19 pandemic

Dedeilia¹,

Esagian²,

Ziogas³

et al. 2020

WJCP

View full text Add to dashboard Cite

show abstract

“…In the absence of a private room, patients are housed in the same room with at least two meters away in between. Each child can only be accompanied by one caregiver who is provided with a surgical facemask and advised to stay in the room with the child at all times [14]. HCW who enter the room of a patient with known or suspected COVID-19 should adhere to standard precautions and use a respirator (or facemask if a respirator is not available), gown, gloves, and eye protection with proper hand hygiene [8].…”

Section: Inside the Hospitalmentioning

confidence: 99%

Practical approach to COVID-19: an Egyptian pediatric consensus

Mostafa

Abdalbaky

Fouda

et al. 2020

Egypt Pediatric Association Gaz

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Background: Outbreak of a novel corona virus was reported in China on December 2019. Sooner, a global spread was reported and WHO announced a public health emergency of international concern and then declared it as a pandemic. Egypt announced the first case on February 14, 2020, and since that time, cases are increasing. Main body: There is increasing need to simplify the practical approach for pediatricians and other health care workers in a step wise manner; how to deal with COVID-19 cases, how to care for the newborn babies as regards to breastfeeding, and how to ensure safety of health care workers assess their risk of infection and management accordingly. A national practical approach guideline was prepared including case definition, diagnosis, and management of pediatric COVID-19 suspected and confirmed cases in an algorithmic pattern. Conclusion: Up to the current knowledge, this is a simple and practical guidance for clinical management of children during the current pandemic.

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“…Although few pediatric cases with COVID-19 are reported in relation to anesthesia, preparation of both the operating room and medical staffs is almost the same required for adult patients [28,29]. Only one parent is allowed to accompany the child to the operating room for induction and should leave the room as soon as the child is asleep.…”

mentioning

confidence: 99%

COVID-19: review of case reports

Oda¹

2020

J Anesth

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Recently published case reports relating to anesthesia in patients with coronavirus disease (COVID-19) were reviewed. The diagnosis of COVID-19 was confirmed by positive results of reverse transcriptase polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Numerous reports handled emergency cesarean delivery. Primary symptoms and laboratory data of pregnant women with COVID-19 were similar to those of non-pregnant patients. Although the mortality rate is reported to be high after surgery in patients with COVID-19, cesarean delivery was successfully performed under regional anesthesia in most cases and postoperative course was favorable both in the parents and newborns. There is no direct evidence of vertical mother-to-child transmission of SARS-CoV-2; however, a diagnosis of COVID-19 was made in a newborn two hours after delivery from a pregnant woman with COVID-19, based on the increased immunoglobulin levels and deranged liver function, suggesting that its possibility cannot be completely eliminated. Emergency cerebral shunt reconstruction was performed repeatedly in an eight-month-old boy with COVID-19. The tracheal tube was removed in the operating room after surgery and postoperative course was uneventful. All the procedures should be performed in isolated operating rooms with medical staff with level-3 personal protection to ensure the safety of patients and health care providers.

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Special considerations for the management of COVID‐19 pediatric patients in the operating room and pediatric intensive care unit in a tertiary hospital in Singapore

Cited by 22 publications

References 12 publications

Pediatric surgery during the COVID-19 pandemic

Pediatric surgery during the COVID-19 pandemic

Practical approach to COVID-19: an Egyptian pediatric consensus

COVID-19: review of case reports

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