Measures adopted for neurosurgical care in times of COVID-19
Keywords:
covid-19, hospital ancillary services, neurosurgery, security measuresAbstract
Introduction: in order to support effective treatment for SARS-CoV-2, it was necessary to develop organizational actions in hospital services for the protection of health personnel and the control of virus transmission.
Objective: to describe the organizational measures adopted for neurosurgical care in times of COVID-19.
Methods: a study with a qualitative approach of the research-action type was carried out at the General Teaching Hospital "Cptan Roberto Rodríguez Fernández" in the Morón municipality in the Ciego de Ávila province, in the period between May/2020-November/2021. Documentary review, participant observation and discussion groups were used. Ethical principles were met.
Results: the action-research process followed the following three interrelated phases: determination of the research problem, formulation of a plan or program to solve the problem, and implementation of the plan with critical reflection and evaluation of results. The final result was made up of the general indications and the five levels of priority for patient care. This was supported by the work of the discussion group of the neurosurgery service.
Conclusions: the general indications and the five priority levels adopted for neurosurgical patient care during the COVID-19 pandemic are presented with the aim of avoiding the transmissibility of the disease between workers and patients.Downloads
References
World Health Organization. Coronavirus disease 2019 (COVID-19): situation report, (2020).70. [Internet]. Geneva: WHO. [citado 22 Jun. 2020]. Disponible en: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
Mao L, Wang M, Chen S, He Q, Chang J, Hong C, et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. MedRxiv [Internet] 2020 [citado 4 Jun 2020].[aprox. 26 p.]. Disponible en: https://seorl.net/wp-content/uploads/2020/03/Mao_Neurological-Manifestations.pdf
Jin H, Hong C, Chen S, Zhou Y, Wang Y, Mao L, et al. Consensus for prevention and management of coronavirus disease 2019 (COVID-19) for neurologists. Stroke Vasc Neurol [Internet]. 2020 [citado 4 Jun 2020];5(2):146-51. Disponible en: https://svn.bmj.com/content/svnbmj/early/2020/05/07/svn-2020-000382.full.pdf
Iorio-Morin C, Hodaie M, Sarica C, Dea N, Westwick HJ, Christie SD, et al. The Risk of COVID-19 Infection During Neurosurgical Procedures: A Review of Severe Acute Respiratory Distress Syndrome Coronavirus 2 (SARS-CoV-2) Modes of Transmission and Proposed Neurosurgery-Specific Measures for Mitigation. Neurosurgery [Internet]. 2020 [4 Jun 2020];15(7):[aprox. 8 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188127/pdf/nyaa157.pdf
Savón-Vladés CE, Acosta-Herrera B, Piñón-Ramos A, Valdés-Ramírez O, Oropesa-Fernández SI, González-Muñoz G. Infección respiratoria aguda grave en pacientes cubanos durante la ola de influenza pandémica A (H1N1) en Cuba. Rev Cubana Med Trop [Internet] 2011 [citado 4 Jun 2020];63(1):30-7. Disponible en: http://scielo.sld.cu/pdf/mtr/v63n1/mtr05111.pdf
Ministerio de Salud Pública (Cuba). Plan para el enfrentamiento de la pandemia Influenza A (H1N1) [Internet]. La Habana: MINSAP; 2009 [4 Jun 2020]. Disponible en: https://files.sld.cu/pdvedado/files/2009/09/final_plan_para_el_enfrentamiento_de_pandemia.pdf
Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms. ACS Chem Neurosci [Internet]. 2020 [4 Jun 2020];11(7):995-98. Disponible en: https://pubs.acs.org/doi/pdf/10.1021/acschemneuro.0c00122
Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARSCoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol [Internet] 2020 [4 Jun 2020];92(6):1-4. Disponible en : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228394/
To KF, Lo AW. Exploring the pathogenesis of severe acute respiratory syndrome (SARS): the tissue distribution of the coronavirus (SARSCoV) and its putative receptor, angiotensin‐converting enzyme 2 (ACE2). J Pathol [Internet]. 2004 [4 Jun 2020];203(3):740‐3. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7167902/pdf/PATH-203-740.pdf
Agosti E, Giorgianni A, Pradella R, Locatelli D. COVID-19 outbreak: single center experience in neurosurgical and neuroradiological emergency network tailoring. World Neurog [Internet]. 2020 [4 Jun 2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184971/pdf/main.pdf
Grelat M, Pommier B, Portet S, Amelot A, Barrey C, Leroy HA. Covid-19 patients and surgery: Guidelines and checklist proposal. World Neurosurg [Internet]. 2020 [4 Jun 2020];139:769-73. Disponible en: https://hal.science/hal-03492227v1/file/S1878875020308627.pdf
Asociación Médica Mundial. Declaración de Helsinki de la AMM. Principios éticos para las investigaciones médicas en seres humanos. Ratificada en la 64ª Asamblea General, Fortaleza, Brasil, octubre 2013. Helsinki: 18ª Asamblea Mundial; 1964 [citado 11 Feb 2020]. Disponible en: http://www.anmat.gov.ar/comunicados/HELSINSKI_2013.pdf
Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill [Internet]. 2020 [4 Jun 2020];25(10):[aprox 5 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078829/pdf/eurosurv-25-10-1.pdf
Patel Z, Fernandez-Miranda J, Hwang P, Nayak J, Dodd R, Sajjadi H, et. al. Precautions for endoscopic transnasal skull base surgery during the COVID-19 pandemic. Neurosurgery [Internet] 2020 [4 Jun 2020];87(1):e66-e67. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184431/pdf/nyaa125.pdf
Wen J, Qi X, Lyon KA, Liang B, Wang X, Feng D, et. al. Lessons from China when Performing Neurosurgical Procedures During the COVID-19 Pandemic. World Neurosurg [Internet]. 2020 [4 Jun 2020];138:e955-e960 Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194527/pdf/main.pdf
Dexter F, Parra MC, Brown JR, Loftus RW. Perioperative COVID-19 defense: an evidence-based approach for optimization of infection control and operating room management. Anesth Analg [Internet]. 2020 [4 Jun 2020];10:[aprox. 10 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172574/pdf/ane-publish_ahead_of_print-10.1213_ane.0000000000004829.pdf
Fuk-Woo-Chan J, Shuofeng Y, Kin-Hang K, Kai-Wang-To K, Chu H, Yang J. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet [Internet]. 2020 [4 Jun 2020];395:514-23. Disponible en: https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930154-9
Zhang W, Du RH, Li B, Zheng XS, Yang XL, Hu B. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg. Microbes Infect [Internet] 2020 [4 Jun 2020];9(1):386-89. Disponible en: https://www.tandfonline.com/doi/epdf/10.1080/22221751.2020.1729071?needAccess=true&role=button
Chen W, Lan Y, Yuan X, Deng X, Li Y, Cau X, et al. Detectable 2019-nCoV viral RNA in blood is a strong indicator for the further clinical severity. Emerg Microbes Infect [Internet]. 2020 [4 Jun 2020];9(1):469-73. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054964/
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet [Internet]. 2020 [4 Jun 2020];395(10223):497-506. Disponible en: https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930183-5
Livingston E, Desai A, Berkwits M. Sourcing personal protective equipment during the COVID-19 pandemic. JAMA [Internet]. 2020 [4 Jun 2020];323(19):1912-14. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/2764031
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