Operating room preparedness to manage future pandemics of airborne infectious diseases: What is needed?

Abstract

The entire world has been in the grip of COVID-19 for more than a year and is susceptible to have further pandemics in future. Although elective surgical procedures should be postponed in infected patients, they may require emergency surgeries. At the beginning of the COVID-19 pandemic, most operating room (OR) setups were not as per the requirements. Hence, several modifications and innovations were made to handle the situation. The existing ORs were converted temporarily into COVID ORs using these modifications. However, now it is well understood that the world is quite susceptible to these types of infectious diseases, and special ORs will be required for surgical management of infected patients. Therefore, it becomes extremely important to prepare dedicated ORs for emergency surgeries in patients with airborne infectious diseases, which can be readily used to manage infected or suspected patients in the event of any future pandemic. We aim to review the current relatively scarce literature and answer some questions about the readiness and methods required for conducting safe surgery during the COVID-19 pandemic, as well as any other such pandemic in future. The preparations are needed in the field of infrastructure, staff requirements and management, equipment and other supplies, and formulation of guidelines for clinical management. The ultimate aim is to prevent spread of infection from the patient to the staff members, OR environment, and other patients without compromising the care of the infected patient. This review highlights these issues and also discusses specific concerns in some special patient populations.

Keywords

• aerosol-generating medical procedures
• airborne infection
• covid-19
• negative pressure ventilation
• operating room preparedness
• pandemic
• personal protective equipment
• surgical practice