April 6, 2020

New algorithm for PPE use aims to protect OR teams from COVID-19 virus

By: Judy Mathias
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Editor's Note

In this study, researchers from Stanford University create an algorithm to protect OR teams who perform urgent and emergency surgical procedures from the coronavirus and rationally conserve the personal protective equipment (PPE) they wear.

Incuded in the decision tree algorithm:


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  • Patients were triaged by severity of illness into urgent and emergency procedures.
  • Urgent procedures were stratified into high- and low-risk depending on the expected viral burden at the surgical site.
  • Procedures categorized as aerosol-generating were classified as high-risk. Included were aerodigestive tract procedures, endoscopy, and open or laparoscopic procedures on the bowel with gross contamination.
  • All patients having emergency procedures were assumed to be infected with COVID-19 until proven otherwise.
  • The surgeon could consider delaying the surgery of patients that screened positive.
  • For emergency cases, the PPE requirements for the entire team were fitted N-95 respirator masks in addition to droplet PPE (ie, gown, gloves, eye protection).
  • Only when testing was negative for COVID-19 could OR team members wear standard surgical attire.

Despite COVID-19 being a new threat, the researchers say that by developing an easy-to-follow decision tree algorithm, they can ensure optimal healthcare worker safety.

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