Challenges and changes in pediatric surgical practice during the COVID-19 pandemic Era

• Main Authors: Nirkhi R Shah (Author), Jaishri Ramji (Author), Maheshkumar Manilal Vaghela (Author), Charul Mehta (Author), Arif Vohra (Author), Rakesh S Joshi (Author)
• Format: Book
• Published: Wolters Kluwer Medknow Publications, 2022-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0971-9261; 1998-3891; 10.4103/jiaps.jiaps_142_21
• Keywords: covid-19; pediatric surgeries; protocols; working practice; Pediatrics; RJ1-570; Surgery; RD1-811
• Source: Journal of Indian Association of Pediatric Surgeons, Vol 27, Iss 4, Pp 455-461 (2022)

Aim: Working practices in pediatric surgery underwent enormous changes during the era of the COVID-19 pandemic. While certain surgical conditions in children can be managed temporarily with nonsurgical options, most neonates with congenital surgical malformations require emergent operations. We discuss the challenges faced; measures adopted in dealing with surgical emergencies and analyze the diagnoses and outcomes of patients with COVID-19 infection in our institute during the pandemic era. Materials and Methods: When the lockdown was imposed, it was mandated that all elective procedures should be put on hold. We formulated criteria for triaging procedures as emergent, urgent, and elective. A standard operating protocol was devised regarding admission, pre and postoperative management. Protocols for surgical procedures were established in a separate Covid-designated operation room including a specified sequence of donning and doffing personal protective equipment. Results: In the COVID era, from March 23, 2020 to mid-July 2021, 1282 surgeries have been done in our department, 344 emergencies and 461 planned procedures, which include 31 COVID-19 positive cases, with overall good outcomes. 103 emergency surgeries were done during the first wave (March-end to June 2020), and 103during the second wave (April to mid-June 2021). Moreover, not a single healthcare worker in the department has been infected. Conclusion: Pediatric Surgeons are adapting to the new guidelines to continue to provide emergency services with safe and effective care to their patients during the COVID-19 pandemic. Simultaneously, focus on personal and staff protection is ensured to keep the healthcare workers healthy and able to discharge their duties adequately.