A recent Op-Ed piece highlighted one of the ways in which the pandemic has improved the quality of care for patients in surgery. Early in the pandemic the American Society of Anesthesiologists and the Anesthesia Patient Safety Foundation, the American College of Surgeons, the Association of periOperative Registered Nurses, and the American Hospital Association set to work to develop recommendations and statements to guide safe surgical care. The author of the piece opined that many of these recommendations will stay in place after the pandemic ends. So, in a way, COVID-19 is making surgery safer.
The guidance documents highlight the importance of preoperative evaluations. Each evaluation is done by surgeon and anesthesiologist, who tailor a surgery and anesthesiology plan for the patient. They consider the emergent nature of the surgery, the patient’s COVID-19 status, and if the patient has a previous COVID-19 infection. This is all by way of evaluating the patient’s readiness for surgery.
Additional patient care changes are important to highlight also. This includes keeping patients and families informed of these many changes. Hospitals and surgical facilities are changing the check in and visiting procedures – some are requesting patients be picked up and dropped off, or are allowing one visitor. Many are compensating for these changes by providing extra support to the patient.
As for the surgery itself, extra precautions are being taken in emergency surgeries for COVID positive or symptomatic patients. This include better fitting and more extensive PPE, negative pressure in the surgical suite, and keeping the patient isolated through recovery.
Of course, the guidance documents are recommending physicians advise their patients to get their COVID vaccine, especially higher risk patients, and especially if the surgery is non-emergent and can wait for several weeks or months, as is the case with hip or knee replacement surgeries.
Additional precautions are being taken with formerly COVID positive patients, which include wait times based on the patient’s COVID symptoms, and measures taken to ensure no chronic symptoms may be problematic during surgery.
While we expect the pandemic to wane, eventually, it is likely many of these protocols will remain in place in slightly altered versions.
