Endoscopy during COVID-19 Pandemic

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Salient Points

This article focuses on the protocols required in maintaining safe and high quality endoscopy practice during the COVID-19 pandemic, in order to ensure safety of health care workers and the prevention of nosocomial spread of infection as well as limit the community spread of infection.

COVID-19 which is caused by SARS-CoV-2 has become a global pandemic. Risk of transmission may occur during endoscopy and the goal is to prevent infection among healthcare professionals while providing essential services to patients. Asia was the first continent to have a COVID-19 outbreak, and this position statement of the Asian Pacific Society for Digestive Endoscopy shares our successful experience in maintaining safe and high-quality endoscopy practice at a time when resources are limited. Statements including patient triage and risk assessment before endoscopy, resource prioritisation and allocation, regular monitoring of personal protective equipment, infection control measures, protective device training and implementation of a strategy for stepwise resumption of endoscopy services after control of the COVID-19 outbreak were included in the article.

Detailed Summary

The following are the guidelines to follow:

  1. Assess the risk of patients with suspected or confirmed COVID-19 before endoscopy is essential.
  2. Elective endoscopies should be reconsidered until further notice during the pandemic.
  3. Urgent endoscopies should be performed by a strategically assigned staff to minimise the exposure.
  4. Medical equipment and resources should be allocated for staff to prepare for a surge in healthcare demand.
  5. Regular monitoring of supply and use of PPE is necessary.
  6. Health care workers must practice standard infection control for endoscopy.
  7. Health care workers must receive adequate training on downing and removal of PPE.
  8. Faecal shedding of SARS-CoV-2 may occur – practice extra precaution during colonoscopies.
  9. Procedure should be performed in a negative pressure room with strict isolation precautions in suspected or confirmed cases of COVID-19.
  10. Disinfection policy for endoscopy rooms and instruments.

Resumption of elective endoscopy services should be guided by control of COVID-19 in the community, availability of manpower and equipment supply.

Reference Link : https://gut.bmj.com/content/early/2020/04/02/gutjnl-2020-321185

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