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COVID-19: implications for surgical suites

COVID-19, the Novel Coronavirus, has inundated hospitals across the country and world with sick patients, at rates not seen in modern-day medicine.

While many hospitals in the United States postponed elective surgeries, emergent surgeries still need to happen during this worldwide pandemic. Life-saving surgeries are necessary, despite the virus, so doctors and patients still face risks.

Shortage Of PPE Cause Risks For Surgeons

The American College Of Surgeons (ACS) recommends surgeons use N95 respirators or respirators that offer "a higher level of protection" when performing or working around an aerosol-generating procedure, such as an OR patient intubation. The ACS recommends disposing of the PPE appropriately per local policy.

However, doctors and nurses throughout the hospital need personal protective equipment (PPE) more than ever, to protect themselves from each potentially infected patient to stop the spread of the virus. With more staff needing PPE, this reduces supplies throughout the hospital and in operating rooms, making it challenging to change the PPE after each patient.

On the ACS website, it admits to this shortage and risk.

"There is a distinct possibility that personal protective equipment, including acceptable masks (such as the N95 mask), may be in short supply," the website states. "Healthcare institutions are encouraged to develop protocols for preserving supplies of masks and protective equipment. The CDC has outlined strategies for optimizing the supply of face masks."

Lack Of Social Distancing

Surgeons and medical staff can't distance themselves from the patient socially. During more normal times, dozens of staff members work in an operating room. Currently, the Center For Disease Control recommends gatherings of no size and people who do not live together staying six feet apart. That is impossible in a hospital and operating room setting.

CDC Recommendations To Protect Surgeons, Staff, And Patients

The CDC recommends hand hygiene before entering the operating room and before exiting regardless of if PPE is worn.

To protect the patient and staff, the CDC recommends reducing the number of personnel in the operating room. Reduced personnel is recommended during intubation, as well as throughout the surgery. Given the current circumstances, visitors and observers in the OR are not recommended.

The ACS strongly recommends using smoke evacuators when electrocautery is employed. There are also concerns about tracheostomy because of the high risk for aerosolization.

After The Operation, Risk Remains For Surgeons

Once the operation is complete, the risk for contracting COVID-19 is not over yet for surgeons and medical staff.

Patient transportation should involve the least possible number of staff. Staff transporting patients must make every effort to reduce contact between the patient being transported and all other people. Have the patient wear PPE and do not allow other staff to be in close quarters, such as in an elevator. During this transport time, staff still need to wear PPE, and it should not be the same PPE that worn during the procedure. Change PPE after every procedure and at least once a day.

The ACS recommends any staff in the OR removes his or her clothes worn from home and keep in a separate garment bag before changing into scrubs at the hospital. After caring for a patient with COVID-19 or is suspected of having COVID-19, shower, and change into clean scrubs whenever possible. Wear different clothes on the way home.

How Can BiPAD® Help?

The ACS has guidelines for electrocautery procedures, and BiPAD® can help meet these guidelines.

During these times, surgeons want to minimize time and risk in the OR. Searching for foot pedals every time they need to cauterize a bleeding vessel leaves room for error and takes time. BiPAD®'s products help eliminate this need.

BiPAD® hand switching for bipolar forceps also helps eliminate surgeon fatigue. Since a foot pedal is used dozens or even hundreds of times during surgery, switching to BiPAD® helps eliminate a source of fatigue for surgeons. Minimizing surgeon fatigue is especially important now, during a pandemic, when surgeons need all the energy and focus they can muster.

Finally, studies have shown that hand switching is faster than foot switching. That, plus reduced time wasted searching for a foot pedal means less time of surgery and less blood loss.


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