Establishing a South African national framework for COVID-19 surgical prioritisation.
S Afr Med J
; 111(5): 426-431, 2021 03 23.
Article
in En
| MEDLINE
| ID: mdl-34852883
ABSTRACT
BACKGROUND:
Since the start of the COVID-19 pandemic, surgical operations have been drastically reduced in South Africa (SA). Guidelines on surgical prioritisation during COVID-19 have been published, but are specific to high-income countries. There is a pressing need for context-specific guidelines and a validated tool for prioritising surgical cases during the COVID-19 pandemic. In March 2020, the South African National Surgical Obstetric Anaesthesia Plan Task Team was asked by the National Department of Health to establish a national framework for COVID-19 surgical prioritisation.OBJECTIVES:
To develop a national framework for COVID-19 surgical prioritisation, including a set of recommendations and a risk calculatorfor operative care.METHODS:
The surgical prioritisation framework was developed in three stages (i) a literature review of international, national and local recommendations on COVID-19 and surgical care was conducted; (ii) a set of recommendations was drawn up based on the available literature and through consensus of the COVID-19 Task Team; and (iii) a COVID-19 surgical risk calculator was developed and evaluated.RESULTS:
A total of 30 documents were identified from which recommendations around prioritisation of surgical care were used to draw up six recommendations for preoperative COVID-19 screening and testing as well as the use of appropriate personal protective equipment. Ninety-nine perioperative practitioners from eight SA provinces evaluated the COVID-19 surgical risk calculator, which had high acceptability and a high level of concordance (81%) with current clinical practice.CONCLUSIONS:
This national framework on COVID-19 surgical prioritisation can help hospital teams make ethical, equitable and personalised decisions whether to proceed with or delay surgical operations during this unprecedented epidemic.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Surgery Department, Hospital
/
Surgical Procedures, Operative
/
Triage
/
Critical Care
/
COVID-19
/
Intensive Care Units
Type of study:
Guideline
/
Prognostic_studies
Aspects:
Ethics
Limits:
Humans
Country/Region as subject:
Africa
Language:
En
Journal:
S Afr Med J
Year:
2021
Document type:
Article
Affiliation country:
South Africa