Surgery

Surgical and post-operative management of COVID-19 patients
  • Surgeons should curtail the performance of “elective” surgical procedures
    • Find guidelines on specific surgical specialties here

 

  • Guidelines for all cases include the following from the American College of Surgeons:
    • Overarching recommendation is to prepare for markedly increased rates over the next few weeks when triaging elective cases at present.
    • Patients should receive appropriate and timely surgical care based on sound surgical judgment and availability of resources.
    • Consider nonoperative management whenever it is clinically appropriate.
    • Consider waiting on results of COVID-19 testing in surgical patients.
    • Avoid emergency surgical procedures at night when possible due to limited team staffing.
    • For patients who are or may be infected, aerosol generating procedures (AGPs) should only be performed while wearing full PPE including an N95 mask or PAPR that has been designed for the OR. Examples of known and possible AGPs include:
      • Intubation, extubation, bag masking, bronchoscopy, chest tubes
      • Electrocautery of blood, gastrointestinal tissue, any body fluids
      • Laparoscopy/endoscopy
    • There are insufficient data to recommend for/against an open versus laparoscopy approach; however, the surgical team should choose an approach that minimizes OR time and maximizes safety for both patients and healthcare staff. 

Sources:

COVID-19: Elective Case Triage Guidelines for Surgical Care. American College of Surgeons. Available from: https://www.facs.org/covid-19/clinical-guidance/elective-case

Last Updated 5 months ago
Elective Surgery Acuity Scale (ESAS)

 

Sources:

COVID-19: Guidance for Triage of Non-Emergent Surgical Procedures. American College of Surgeons. Available from: https://www.facs.org/covid-19/clinical-guidance/triage

Last Updated 5 months ago
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