The management of surgical patients in the emergency setting during COVID-19 pandemic: the WSES position paper

World Journal of Emergency Surgery

Ari Leppänemi¹  Gustavo P. Fraga²  Edoardo Picetti³  Luca Ansaloni⁴  Fausto Catena⁵  Yoram Kluger⁶  Massimo Sartelli⁷  Salomone Di Saverio⁸  Massimo Valentino⁹  Emmanouil Pikoulis^1,10  Fikri M. Abu-Zidan^1,11  Gian Luca Baiocchi^1,12  Federico Coccolini^1,13  Walter L. Biffl^1,14  Leonardo Pagani^1,15  Elie Chouillard^1,16  Belinda De Simone^1,16  Ciro Paolillo^1,17  Ernest E. Moore^1,18  Andrew B. Peitzmann^1,19 

[1] Abdominal Center, University Hospital Meilahti;Departamento de Cirurgia, Faculdade de Ciências Médicas (FCM) –Unicamp;Department of Anesthesia and Intensive Care, Parma University Hospital;Department of Emergency and Trauma Surgery, Bufalini Hospital;Department of Emergency and Trauma Surgery, Parma University Hospital;Department of Emergency and Trauma Surgery, Rambam Health Campus;Department of General Surgery, Macerata’s Hospital;Department of General Surgery, University Hospital of Varese, University of Insubria;Department of Radiology, Tolmezzo Hospital;Department of Surgery, Attikon General Hospital, National & Kapodistrian University of Athens (NKUA);Department of Surgery, College of Medicine and Health Sciences, UAE University;Department of Surgery, University of Brescia;Department of Surgery, University of Pisa;Department of Trauma and Acute Care Surgery, Scripps Memorial Hospital;Infectious Diseases Unit, Bolzano Central Hospital;Service de Chirurgie Générale, Digestive, Metabolique, Centre Hospitalier de Poissy/Saint Germain en Laye;Spedali Civili di Brescia, ASST degli Spedali Civili di Brescia;Trauma Surgery, Denver Health;University of Pittsburgh School of Medicine;

关键词: COVID-19;    Emergency surgery;    Personal protective equipment;    2019-nCoV;    SARS-CoV-2;    Laparoscopy;   

DOI  :  10.1186/s13017-021-00349-0

来源: DOAJ

【 摘 要 】

Abstract Background Since the COVID-19 pandemic has occurred, nations showed their unpreparedness to deal with a mass casualty incident of this proportion and severity, which resulted in a tremendous number of deaths even among healthcare workers. The World Society of Emergency Surgery conceived this position paper with the purpose of providing evidence-based recommendations for the management of emergency surgical patients under COVID-19 pandemic for the safety of the patient and healthcare workers. Method A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) through the MEDLINE (PubMed), Embase and SCOPUS databases. Synthesis of evidence, statements and recommendations were developed in accordance with the GRADE methodology. Results Given the limitation of the evidence, the current document represents an effort to join selected high-quality articles and experts’ opinion. Conclusions The aim of this position paper is to provide an exhaustive guidelines to perform emergency surgery in a safe and protected environment for surgical patients and for healthcare workers under COVID-19 and to offer the best management of COVID-19 patients needing for an emergency surgical treatment. We recommend screening for COVID-19 infection at the emergency department all acute surgical patients who are waiting for hospital admission and urgent surgery. The screening work-up provides a RT-PCR nasopharyngeal swab test and a baseline (non-contrast) chest CT or a chest X-ray or a lungs US, depending on skills and availability. If the COVID-19 screening is not completed we recommend keeping the patient in isolation until RT-PCR swab test result is not available, and to manage him/she such as an overt COVID patient. The management of COVID-19 surgical patients is multidisciplinary. If an immediate surgical procedure is mandatory, whether laparoscopic or via open approach, we recommend doing every effort to protect the operating room staff for the safety of the patient.

【 授权许可】

Unknown