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Covid-19 Testing Prior to Medical Procedures Could Manage PPE

Universal testing for Covid-19 prior to procedures could help manage PPE use and help determine risk for healthcare providers.

As we look toward a second wave of coronavirus infections and PPE shortages, the medical community continues to look for ways to manage supplies. Universal testing for Covid-19 might be one of those ways, suggests research presented at the Anesthesiology 2020 annual meeting. Specifically, researchers found that by testing children before any medical procedures that use anesthesia, one could rule out Covid-19 and prevent the unnecessary use of the extensive PPE recommended by the CDC.

When treating Covid-19 patients, the CDC recommends the addition of a respirator mask, such as an N95 or PAPR, and a gown, to the standard PPE of a surgical mask, eye protection, and gloves. What’s more, many hospitals frequently verbally screen patients for Covid-19 by asking them about their travel history, close contact or exposure to the disease, and symptoms such as fever, cough, or shortness of breath. However, this screening does not confirm or deny whether the patient has been infected by the virus, whether the screen is positive or negative.

For this study, researchers analyzed the results of Covid-19 testing of 1,033 children requiring anesthesia for a wide range of procedures, from MRI testing to cancer surgery and appendix removal at the Children’s Hospital of Philadelphia between March 26th and May 11th, 2020. All children were tested for Covid-19 using the polymerase chain reaction (PCR) test before receiving anesthesia. They then compared the test results to those suspected of being infected based on the verbal screening method.

One hundred forty-six children verbally screened positive for at least one of the three criteria. Without Covid-19 PCR testing, healthcare providers treating the children would have been required to wear expanded PPE. However, 102 of the 146 patients had a negative Covid-19 PCR test and received care with standard PPE. This reduced the amount of extended PPE use by 70%. In addition, ten children verbally screened negative for the virus and then tested positive for Covid-19. They may have otherwise been overlooked, increasing healthcare workers’ risk of exposure.

“This study links the importance of universal testing for Covid-19, increased safety of staff, and efficient use of PPE, especially items such as N95 face masks, which are in low supply,” Lenard Babus, M.D., lead author of the study and attending pediatric anesthesiologist, Children’s Hospital of Philadelphia, said in a statement. “If universal testing were used outside the hospital, outpatient facilities and other treatment centers could experience similar PPE and safety benefits.”

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