SMS Hospital, India
The Coronavirus (COVID-19) pandemic has resulted in over 13 million confirmed cases and over half a million deaths worldwide. The impact of COVID-19 on day to day surgical practice is massive, from workforce and manpower issues, intraoperative risks for transmission, evelopment of a triage for the interventional procedures, changes to postoperative and preoperative practice and the impacts on surgical education and training. Whilst we witness the growing literature studies describing the complete clinical course of COVID-19 and the different aspects of critical care for the positive patients, there has not been much clear idea on how this pandemic will affect surgical practice.
We came across seven unique scenarios during our routine and emergency surgical work. This is just to help the surgeons to keep in mind these type of scenarios during their surgical tenure.
Seven unique scenarios were Identified:
1. COVID positive patient, with a surgical pathology.
2. COVID positive patient incidentally diagnosed to have a surgical pathology.
3. COVID Negative Surgical patient with COVID positive symptomatology.
4. A COVID negative surgical patient acquiring nosocomial COVID infection postoperatively.
5. COVID positive surgical patient with false negative COVID report.
6. Incidental Intraoperative findings substantiating postoperative COVID test positive case.
7. COVID positive patients who require elective surgical interventions
Conclusions: After keeping all these scenarios in mind, a customised guideline should be framed for each kind of presentation. A further research and randomised controlled trial is required to reach to level 1 evidence and its results.
Keywords: COVID-19, Surgery, Institutional Protocol, Healthcare workers
Sumita A Jain is a Senior Professor of Surgery and head of a unit in SMS Medical College and Hospital in Jaipur. Among her vast academic accomplishments, she holds the honor of topping the Rajasthan Public Service Commission (RPSC) examination in 1995. She was awarded the Vivekanand Gaurav Sammaan in 2007. She has authored numerous international publications, including a worldwide prospective observational study of sepsis severity score on acute appendicitis published in the World Journal of Emergency Surgery. She has also served as a panelist in several important discussions on Breast Cancer including CPG Oncology and Breast Cancer Update.She was invited as a faculty speaker at World Cancer Congress Miami, Breast Congress in Rome and APHC in Philippines. She is the founder and president of Women Cancer Society, Rajasthan, a NGO working to increase awareness about breast cancer among women of Rural Rajasthan.
McGill University, Canada
Traumatic cardiac arrest (TCA) should be thought of in a different treatment paradigm than medical cardiac arrest (MCA). This presentation will focus on the key principles of diagnosis and approach to-TCA with emphasis on the vital differences and subsequent management in pathophysiology between -TCA and MCA.
Joe Nemeth started his post-graduate training in pediatric and internal medicine transitioning eventually into emergency medicine. He has been an attending physician at the McGill University Health Centre's Montreal General Hospital, Royal Victoria Hospital and Montreal Children's Hospital since 2001. Besides adult and pediatric emergency medicine, he has a passion for trauma. He has been a trauma team leader since the inception of the TTL program at the MGH in 2005. He is also the fellowship director of the TTL fellowship.