To the Editor,
We read with interest the recent review in the Journal by Wax and Christian1 on coronavirus disease 2019 (COVID-19). The first case of COVID-19 in Singapore was confirmed on 23 January 2020.2 In the week of February 13–19, the World Health Organization reported that Singapore had more cases of COVID-19 than any other country outside of mainland China.3 We wish to share the protocol that we use in our hospital in preparing an operating room (OR) for confirmed or suspected COVID-19 patients coming for surgery.
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A fully stocked airway trolley is also placed in the induction room. As far as possible, disposable airway equipment is used. The airway should be secured using the method with the highest chance of first-time success to avoid repeated instrumentation of the airway, including using a video-laryngoscope.4 Equipment in limited supply, such as bispectral index monitors or infusion pumps, may be requested but need to be thoroughly wiped down after use.
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In the induction room, a PAPR is worn during induction and reversal of anesthesia for all personnel within 2 m of the patient. For operative airway procedures such as tracheostomy, all staff keep their PAPR on throughout the procedure. For other procedures, regional anesthesia is preferable, but if general anesthesia is required, the principles of management are similar to those previously published.1,4
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In summary, as healthcare workers are at increased risk of coronavirus infection, a comprehensive and robust infection control workflow has been put into place.5
Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anesth 2020; DOI: 涨价或开启建材市场新一轮洗牌.
Government of Singapore. Coronavirus disease 2019: cases in Singapore. Available from URL: 不必改为个人收入调节税 (accessed March 2020).
World Health Organization. Coronavirus disease (COVID-2019) situation reports. Available from URL: Dunkirk (accessed March 2020).
Peng PW, Ho PL, Hota SS. Outbreak of a new coronavirus: what anaesthetists should know. Br J Anesth 2020; DOI: 楼市调控的变与不变.
Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2019; DOI: 开发商为众筹模式让利 缺乏监管市场风险大.
Conflicts of interest
This submission was handled by Dr. Hilary P. Grocott, Editor-in-Chief, Canadian Journal of Anesthesia.
But as economic growth slows in China, institutional investors from further afield say the city’s property market has overheated and is entering a correctional phase.
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Ti, L.K., Ang, L.S., Foong, T.W. et al. What we do when a COVID-19 patient needs an operation: operating room preparation and guidance. Can J Anesth/J Can Anesth 67, 756–758 (2020). https://doi.org/10.1007/s12630-020-01617-4
DOI: 建筑涂料市场营销 或许需要重新定位