Authors (including presenting author) :
Lo PS(1), Mok KW(1), Wong CW(1), Yu MY(1), Yeung YM(1), O SC(1), Lui ML(1)
Affiliation :
(1)Operating Theatre, Department of Anaesthesia, PYNEH
Introduction :
During the early COVID-19 pandemic, we had experienced the first confirmed pregnant patient requiring Cesarean Section. However, there was scarce information from published scientific reports about the severity of COVID-19 infection in pregnant patients and the ways to maintain perioperative safety in these uncertain times. In order to improve staff readiness, minimize risks, and streamline the care processes, a multidisciplinary team was established to formulate a protocol trying to achieve an optimal management for the patient and her baby under a safe and protective way.
Objectives :
We aimed to share our experience in preparation and response planning for the operating room in managing the COVID-19 pregnant patient coming for surgery.
Methodology :
A multidisciplinary team was called from different specialties including anaesthetists, obstetricians, paediatricians, infection control team and the nurses from related departments to address the multifaceted safety concerns associated with the management of the pregnant patient particularly in her late stage of pregnancy and mode of delivery. Members reviewed recommendations from national regulatory bodies and recently published peer reviewed literature. Protection of staff and patients, environmental concerns, other logistic and equipment issues are considered all through the perioperative journey. We had summarized a list of surgical huddles and was used in conjunction of surgical safety checklist to provide the safest arena for the team and patient.
Result & Outcome :
Based on the formulated protocol, Caesarean Section was medically justified. The surgical team implemented strategies for containing the virus and protecting the safety and well-being of their patients and perioperative personnel. None of the staff acquired COVID-19 after surgery, the glitches were captured and highlighted in the surgical debriefing in considering our way forward.
In such a difficult time of COVID-19 outbreak, there is limited time for elaborate planning and training. Despite the uncertainty and fear when the disease first appeared, the authors took on the challenges that were thrown at them one at a time. A clear direction from their leaders, confidence in their training, and great teamwork and spirit without compromising on personal safety played key roles in the rapid formulation of crisis plans and workflow.
