quaternary ammonium compound and alcohol.
If the prevalence of COVID-19 is high in your community, or if
patient testing is not being done, conduct initial Phase I recovery in
the OR instead of the PACU when general anesthesia is used or fol-
lowing an aerosol-producing procedure. With patients coughing after
extubation, and mildly disoriented or with some bronchospasm after
extubation, environmental contamination can occur from sputum.
Remember, the coronavirus can remain active for four days on plastic
and stainless steel surfaces. The goal is to reduce the chance an
asymptomatic COVID-19 patient who tested false negative infects the
PACU.
In communities with a high prevalence of COVID-19 or in facilities
where testing of all patients does not occur, OR cleaning between
cases will be much longer after some procedures. In these ORs, con-
sider employing multimodal environmental decontamination after
every case, including UV-C light or similar technology. Also account
for additional OR time where Phase I recoveries are monitored in
ORs. If possible, dedicate surgeries involving general anesthesia
exclusively to specific ORs to reduce the overall impact on your
throughput.
Some surgery centers have been hesitant to embrace local and
regional anesthesia for qualified procedures. But by removing the
need to intubate and extubate patients, initial recovery times and risk
of transmission are greatly reduced.
Ramp up deliberately. The greatest throughput can be achieved
safely by dedicating many of your ORs to short-duration procedures
that aren't aerosol-producing and can be performed without general
anesthesia. Conveniently, these cases make up the majority of outpa-
tient procedures. In addition to there being no need for airborne pre-
cautions when regional blocks are used, you can turn these cases
Infection Prevention
IP
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