Establishing a South African national framework for COVID-19 surgical prioritisation
Date
2021-03-23
Journal Title
Journal ISSN
Volume Title
Publisher
Health & Medical Publishing Group
Abstract
Background. Since the start of the COVID-19 pandemic, surgical operations have been drastically reduced in South Africa (SA). Guidelines on surgical prioritisation during COVID-19 have been published, but are specific to high-income countries. There is a pressing need for context-specific guidelines and a validated tool for prioritising surgical cases during the COVID-19 pandemic. In March 2020, the South African National Surgical Obstetric Anaesthesia Plan Task Team was asked by the National Department of Health to establish a national framework for COVID-19 surgical prioritisation.
Objectives. To develop a national framework for COVID-19 surgical prioritisation, including a set of recommendations and a risk calculator
for operative care.
Methods. The surgical prioritisation framework was developed in three stages: (i) a literature review of international, national and local recommendations on COVID-19 and surgical care was conducted; (ii) a set of recommendations was drawn up based on the available literature and through consensus of the COVID-19 Task Team; and (iii) a COVID-19 surgical risk calculator was developed and evaluated.
Results. A total of 30 documents were identified from which recommendations around prioritisation of surgical care were used to draw up six recommendations for preoperative COVID-19 screening and testing as well as the use of appropriate personal protective equipment. Ninety-nine perioperative practitioners from eight SA provinces evaluated the COVID-19 surgical risk calculator, which had high acceptability and a high level of concordance (81%) with current clinical practice.
Conclusions. This national framework on COVID-19 surgical prioritisation can help hospital teams make ethical, equitable and personalised decisions whether to proceed with or delay surgical operations during this unprecedented epidemic.
Description
CITATION: Chu, K. M. et al. 2021. Establishing a South African national framework for COVID-19 surgical prioritisation. South African Medical Journal, 111(5):426-431, doi:10.7196/SAMJ.2021.v111i5.15603.
The original publication is available at http://www.samj.org.za
The original publication is available at http://www.samj.org.za
Keywords
Surgery, elective -- South Africa -- Planning, Covid-19 (Disease) -- Prevention -- South Africa, Emergency management -- South Africa, Public health -- South Africa, Epidemics -- Safety measures -- South Africa, Surgery, elective -- Standards
Citation
Chu, K. M. et al. 2021. Establishing a South African national framework for COVID-19 surgical prioritisation. South African Medical Journal, 111(5):426-431, doi:10.7196/SAMJ.2021.v111i5.15603.