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01-12-2021 | Computed Tomography | Research article

The management of surgical patients in the emergency setting during COVID-19 pandemic: the WSES position paper

Authors: Belinda De Simone, Elie Chouillard, Massimo Sartelli, Walter L. Biffl, Salomone Di Saverio, Ernest E. Moore, Yoram Kluger, Fikri M. Abu-Zidan, Luca Ansaloni, Federico Coccolini, Ari Leppänemi, Andrew B. Peitzmann, Leonardo Pagani, Gustavo P. Fraga, Ciro Paolillo, Edoardo Picetti, Massimo Valentino, Emmanouil Pikoulis, Gian Luca Baiocchi, Fausto Catena

Published in: World Journal of Emergency Surgery | Issue 1/2021

Abstract

Background

Since the COVID-19 pandemic has occurred, nations showed their unpreparedness to deal with a mass casualty incident of this proportion and severity, which resulted in a tremendous number of deaths even among healthcare workers. The World Society of Emergency Surgery conceived this position paper with the purpose of providing evidence-based recommendations for the management of emergency surgical patients under COVID-19 pandemic for the safety of the patient and healthcare workers.

Method

A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) through the MEDLINE (PubMed), Embase and SCOPUS databases. Synthesis of evidence, statements and recommendations were developed in accordance with the GRADE methodology.

Results

Given the limitation of the evidence, the current document represents an effort to join selected high-quality articles and experts’ opinion.

Conclusions

The aim of this position paper is to provide an exhaustive guidelines to perform emergency surgery in a safe and protected environment for surgical patients and for healthcare workers under COVID-19 and to offer the best management of COVID-19 patients needing for an emergency surgical treatment.

We recommend screening for COVID-19 infection at the emergency department all acute surgical patients who are waiting for hospital admission and urgent surgery. The screening work-up provides a RT-PCR nasopharyngeal swab test and a baseline (non-contrast) chest CT or a chest X-ray or a lungs US, depending on skills and availability. If the COVID-19 screening is not completed we recommend keeping the patient in isolation until RT-PCR swab test result is not available, and to manage him/she such as an overt COVID patient.

The management of COVID-19 surgical patients is multidisciplinary.

If an immediate surgical procedure is mandatory, whether laparoscopic or via open approach, we recommend doing every effort to protect the operating room staff for the safety of the patient.

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Title: The management of surgical patients in the emergency setting during COVID-19 pandemic: the WSES position paper
Authors: Belinda De Simone
Elie Chouillard
Massimo Sartelli
Walter L. Biffl
Salomone Di Saverio
Ernest E. Moore
Yoram Kluger
Fikri M. Abu-Zidan
Luca Ansaloni
Federico Coccolini
Ari Leppänemi
Andrew B. Peitzmann
Leonardo Pagani
Gustavo P. Fraga
Ciro Paolillo
Edoardo Picetti
Massimo Valentino
Emmanouil Pikoulis
Gian Luca Baiocchi
Fausto Catena
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Computed Tomography
Laparoscopy
Computed Tomography
SARS-CoV-2
COVID-19
Published in: World Journal of Emergency Surgery / Issue 1/2021
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/s13017-021-00349-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The management of surgical patients in the emergency setting during COVID-19 pandemic: the WSES position paper

Abstract

Background

Method

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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