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2020 ; 168
(3
): 404-407
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
The Boston Medical Center Coronavirus Disease 2019 (COVID-19) Procedure Team:
Optimizing the surgeon s role in pandemic care at a safety-net hospital
#MMPMID32624225
Aly S
; Talutis SD
; Richman AP
; Hess DT
; McAneny D
; Tseng JF
; Drake FT
Surgery
2020[Sep]; 168
(3
): 404-407
PMID32624225
show ga
BACKGROUND: The coronavirus disease 2019 pandemic has claimed many lives and
strained the US health care system. At Boston Medical Center, a regional
safety-net hospital, the Department of Surgery created a dedicated coronavirus
disease 2019 Procedure Team to ease the burden on other providers coping with the
surge of infected patients. As restrictions on social distancing are lifted,
health systems are bracing for additional surges in coronavirus disease 2019
cases. Our objective is to quantify the volume and types of procedures performed,
review outcomes, and highlight lessons for other institutions that may need to
establish similar teams. METHODS: Procedures were tracked prospectively along
with patient demographics, immediate complications, and time from donning to
doffing of the personal protective equipment. Retrospective chart review was
conducted to obtain patient outcomes and delayed adverse events. We hypothesized
that a dedicated surgeon-led team would perform invasive bedside procedures
expeditiously and with few complications. RESULTS: From March 30, 2020 to April
30, 2020, there were 1,196 coronavirus disease 2019 admissions. The Procedure
Team performed 272 procedures on 125 patients, including placement of 135
arterial catheters, 107 central venous catheters, 25 hemodialysis catheters, and
4 thoracostomy tubes. Specific to central venous access, the average procedural
time was 47 minutes, and the rate of immediate complications was 1.5%, including
1 arterial cannulation and 1 pneumothorax. CONCLUSION: Procedural complication
rate was less than rates reported in the literature. The team saved approximately
192 hours of work that could be redirected to other patient care needs. In times
of crisis, redeployment of surgeons (who arguably have the most procedural
experience) into procedural teams is a practical approach to optimize outcomes
and preserve resources.