Patient Selection for Surgery
Recommendations for patients having AGPs and/or co-morbidities:
- Patients with negative history AND negative for COVID-19 antigen testing will be booked for elective surgery
- Patients need to self-isolate for a minimum 7 days prior to surgery and 14 days after the surgery.
- Because false-negatives may occur with testing, droplet precautions (surgical mask and eye covering) should be used by theatre staff for operative cases. Before performing an aerosol- generating procedure, health care providers within the room should wear appropriate PPE.
- If a patient tests positive for SARS-CoV-2, elective surgical procedure should be delayed until the patient is no longer infectious and has demonstrated full symptomatic recovery from COVID-19 if symptomatic and repeat antigen testing is negative. The test should be repeated at least 14 days after the positive result or 14 days of being asymptomatic.
- Recommendations regarding the definition of sufficient recovery from the physiologic changes from SARS-CoV-2 cannot be made at this time; however, evaluation may include an assessment of the patient’s exercise capacity or CT scan findings.
CT chest is not recommended for asymptomatic patients but has some utility in patients who will require ITU post operatively or abdominal surgery. However HSH Day surgery is not suitable for these operations. Patients should be referred to another unit which has ITU facilities.
Point of care testing (60- 90 minutes) could become a care standard however at present there is insufficient test capacity, and currently best reserved for the emergency cases.