1. Neurosurgical Practice During Coronavirus Disease 2019 (COVID-19) Pandemic
- Author
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Zafer Orkun Toktaş, Baris Ozoner, Teyyup Hasanov, Turker Kilic, and Abuzer Güngör
- Subjects
medicine.medical_specialty ,2019-20 coronavirus outbreak ,2019-nCoV, 2019 novel coronavirus ,Coronavirus disease 2019 (COVID-19) ,Health Personnel ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,Clinical Neurology ,UCSF, University of California San Francisco ,CNS, central nervous system ,SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 ,CSF, cerebrospinal fluid ,Article ,Neurosurgical Procedures ,coronavirus disease 2019 ,Betacoronavirus ,operation room ,PCR, polymerase chain reaction ,Pandemic ,medicine ,Humans ,scheduling ,Intensive care medicine ,Pandemics ,Personal Protective Equipment ,COVID-19, coronavirus disease 2019 ,W, weighted ,SARS-CoV-2 ,business.industry ,Operation room ,COVID-19 ,central nervous system ,viral exposure ,CT, computed tomography ,PAPR, powered air-purifying respirators ,FFP, filtering face piece ,RNA, ribonucleic acid ,Surgery ,telemedicine ,Neurology (clinical) ,Coronavirus Infections ,business ,MRI, magnetic resonance imaging ,PPE, personal protective equipment ,severe acute respiratory syndrome coronavirus 2 - Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a highly contagious life-threatening condition with unprecedented impacts for worldwide societies and health care systems. Since the first detection in China, it has spread rapidly worldwide. The increased burden has substantially affected neurosurgical practice and intensive modifications have been required in surgical scheduling, inpatient and outpatient clinics, management of emergency cases, and even in academic activities. In some systems, nonoverlapping teams have been created to minimize transmission among health care workers. In cases of a massive burden, neurosurgeons may need to be reassigned to COVID-19 wards, or teams from other regions may need to be sent to severely affected areas. Recommendations are as following. In outpatient practice, if possible, appointments should be undertaken via telemedicine. All staff assigned to the non-COVID treatment unit should be clothed in level 1 personal protective equipment. If possible, postponement is recommended for operations that do not require urgent or emergent intervention. All patients indicated for surgery must receive COVID-19 screening, including a nasopharyngeal swab and thorax computed tomography. Level 2 protection measures are appropriate during COVID-19-negative patients' operations. Operations of COVID-19-positive patients and emergency operations, in which screening cannot be obtained, should be performed after level 3 protective measures. During surgery, the use of high-speed drills and electrocautery should be reduced to minimize aerosol production. Screening is crucial in all patients because the surgical outcome is highly mortal in patients with COVID-19. All educational and academic conferences can be undertaken as virtual webinars.
- Published
- 2020
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