Last update: June 17, 2020
This is meant to be a guidance document for UMMC. There are also best practice documents available from national surgical and anesthesia societies. The most important part of this document is the planning and preparation phase.
The “rapid” test is now available in limited quantities at UMMC. The run time on this test is 51 minutes and the turnaround from collection to result is about 1.5 to 2 hours. The perioperative areas have been allocated 10 of these tests per week. At this point, the best use for these tests is for instances of urgent or emergent procedures, posted as Level O, A or B, in which the patient can’t undergo reliable symptom screening (i.e. AMS/ICU) or when the patient has a positive screen.
Given the small supply of these tests, we will be very selective of the situations in which we use them. For the perioperative areas, Dr. Chris Anderson will need to approve their use. Please contact Dr. Anderson if you have a situation similar to those outlined above where the rapid test may be useful.
Please familiarize yourself with guidelines for:
Please also see the guidelines below for the use of PPE during transportation of COVID-19 suspected or confirmed patients, including those more detailed by the Critical Care Transport Team.
The surgical team should review the logistics and plan specifically where intubation and extubation will occur. Consideration should be given to intubation in a negative pressure room if it is safe for the patient. The same consideration should be given for extubation. The plan for the post-operative recovery should be reviewed.
We recommend avoiding laparoscopy in known COVID patients if possible. If this is best for the patient, use the smoke evacuation systems throughout the case. Desufflate the abdomen through the in-line filter. Do not evacuate or desufflate the abdomen by opening the trocar valve.