Safety measures for COVID-19: a review of surgical preparedness at four major medical centres in Saudi Arabia
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REVIEW
Open Access
Safety measures for COVID-19: a review of surgical preparedness at four major medical centres in Saudi Arabia Mohammad A. Alsofyani1, Haifaa M. Malaekah2* , Ahmed Bashawyah3, Mohammed Bawazeer4, Khalid Akkour5, Sultan Alsalmi6, Abdu Alkhairy7, Nayef Bin Dajim8, Salahaddeen Khalifah8, Ibrahim A. Almalki9, Farid Kassab10, Mohammad Barnawi11, Mosfer Almalki12, Mohammed Alharthi13, Majed Alharthi14, Abdulaziz Almalki15, Abdullah H. Almalki16, Anouar Bourghli17 and Ibrahim Obeid18
Abstract In view of the worldwide coronavirus disease 2019 (COVID-19) pandemic, hospitals need contingency planning. This planning should include preparation for an unexpected patient surge. This measure is evolving concomitantly with the implementation of the needed infection control rules. Here, we present our experience in contingency planning at four large tertiary hospitals in Saudi Arabia during this global pandemic, with a focus on dealing with COVID-19 patients who need to undergo surgery. The planning covers response measures required in the operating room and supporting units, including the administrative department, intensive care unit, and different sections of the surgical department. Furthermore, it covers the role of education and simulation in preparing health care providers and ensuring smooth workflow between all sections. We additionally discuss the guidelines and policies implemented in different surgical specialties. These measures are necessary to prevent the transmission of COVID-19 within healthcare facilities. Throughout the COVID-19 pandemic, the healthcare system should develop a comprehensive pandemic plan and set guidelines addressing the management of urgent and malignant cases. The guidelines should be in concordance with internal guidelines. Keywords: COVID-19, Anaesthesia, Surgery, Guideline, Simulation
Background Coronavirus disease 2019 (COVID-19) was first recorded as a case of pneumonia caused by an unknown pathogen in Wuhan, the capital city of the Hubei Province in China, in December 2019 [1]. Coronaviruses are a group of enveloped, positive-single-stranded RNA viruses [2]. The coronavirus that causes COVID-19 is known as severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). SARS-CoV-2 is mainly transmitted through * Correspondence: [email protected] 2 General Surgery Department, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia Full list of author information is available at the end of the article
respiratory droplets and person-to-person contact; however, past experience with SARS-CoV in 2003 suggests the possibility of airborne spread in a relatively closed area—i.e., when individuals are exposed to high concentrations of aerosols for a long time, most commonly following tracheal intubation [3]. COVID-19 symptoms are similar to those of other upper respiratory diseases: fever, cough, dyspnoea, and fatigue [4]. However, the symptoms can be nonspecific, especially in elderly and immunocompromise
