Surgery triage during the COVID‐19 pandemic
Open Access
- 20 July 2020
- journal article
- research article
- Published by Wiley in Anz Journal of Surgery
- Vol. 90 (9), 1558-1565
- https://doi.org/10.1111/ans.16196
Abstract
Background The novel coronavirus, SARS‐CoV‐2, caused the COVID‐19 global pandemic. In response, the Australian and New Zealand governments activated their respective emergency plans and hospital frameworks to deal with the potential increased demand on scarce resources. Surgical triage formed an important part of this response to protect the healthcare system’s capacity to respond to COVID‐19. Method A rapid review methodology was adapted to search for all levels of evidence on triaging surgery during the current COVID‐19 outbreak. Searches were limited to PubMed (inception to 10 April 2020) and supplemented with grey literature searches using the Google search engine. Further, relevant articles were also sourced through the RACS COVID‐19 Working Group. Recent government advice (May 2020) is also included. Results This rapid review is a summary of advice from Australian, New Zealand and international speciality groups regarding triaging of surgical cases, as well as the peer‐reviewed literature. The key theme across all jurisdictions was to not compromise clinical judgment and to enable individualised, ethical and patient‐centred care. The topics reported on include implications of COVID‐19 on surgical triage, competing demands on healthcare resources (surgery versus COVID‐19 cases), and the low incidence of COVID‐19 resulting in a possibility to increase surgical caseloads over time. Conclusion During the COVID‐19 pandemic, urgent and emergency surgery must continue. A carefully staged return of elective surgery should align with a decrease in COVID‐19 caseload. Combining evidence and expert opinion, schemas and recommendations have been proposed to guide this process in Australia and New Zealand.Keywords
This publication has 18 references indexed in Scilit:
- A call to arms: a perspective on safe general surgery in Singapore during the COVID-19 pandemicSingapore Medical Journal, 2020
- Managing COVID-19 in Surgical SystemsAnnals of Surgery, 2020
- Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19)cclm, 2020
- Maximizing the Calm before the Storm: Tiered Surgical Response Plan for Novel Coronavirus (COVID-19)Journal of the American College of Surgeons, 2020
- Letter: The Coronavirus Disease 2019 Global Pandemic: A Neurosurgical Treatment AlgorithmNeurosurgery, 2020
- COVID-19 Outbreak and Surgical PracticeAnnals of Surgery, 2020
- COVID-19, an emerging coronavirus infection: advances and prospects in designing and developing vaccines, immunotherapeutics, and therapeuticsHuman Vaccines & Immunotherapeutics, 2020
- Development of a resource modelling tool to support decision makers in pandemic influenza preparedness: The AsiaFluCap SimulatorBMC Public Health, 2012
- GDNF protects enteric glia from apoptosis: evidence for an autocrine loopBMC Gastroenterology, 2012
- Triage in public health emergencies: ethical issuesInternal and Emergency Medicine, 2010