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COVID-19: Updated Infection Prevention and Control Guidance

Released on - 06/07/2020

COVID-19: Updated Infection Prevention and Control Guidance

COVID-19: Updated Infection Prevention and Control Guidance

Reducing the risk of transmission of COVID-19 in the hospital setting (Version 3.2 revised 18 June 2020 chapter 4)

As the current Coronavirus (COVID-19) continues to present significant challenges for healthcare providers both in the independent sector and the NHS. Healthcare professionals who are involved in receiving patients confirmed positive for COVID-19 in the perioperative setting, require the best evidence-based guidance on infection prevention control. The following published guidance seeks to ensure a consistent and resilient UK approach, as differences in operational details and organisational responsibilities may apply across the four UK countries. 

The following official guidance issued jointly by the Department of Health and Social Care (DHSC), Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS) and Public Health England (PHE) provides information to assist with standard infection control precautions (SICPs) and infection prevention in the perioperative setting 2020.

In addition to SICPs, transmission-based precautions (TBP’s) for pandemic COVID-19, droplet precautions should be used for patients known or suspected of being infected with COVID-19 in all healthcare settings.

The following key guidance for theatres: 

4.8. Operating theatres (where these continue to be used for surgery)

It is recommended that ventilation in both laminar flow and conventionally ventilated theatres should remain fully on during surgical procedures where patients may have COVID-19 infection. Air can bypass filtration if a respirator is not fitted perfectly or becomes displaced during use. Those closest to aerosol generation procedures are most at risk. The rapid dilution of these aerosols by operating theatre ventilation will protect operating room staff. Air passing from operating theatres to adjacent areas will be highly diluted and is not considered to be a risk.

  • theatres must be informed in advance of a patient transfer of a confirmed or possible COVID-19 positive case
  • the patient should be transported directly to the operating theatre and should wear a surgical mask if it can be tolerated
  • the patient should be anaesthetised and recovered in the theatre with minimum staff present. Staff should wear protective clothing but only those within 2 metres of an aerosol generating procedure, such as performing intubation, need to wear FFP3 respirators, disposable fluid repellent coveralls or long sleeved gowns, gloves and eye protection. Considerations about the use of respiratory/anaesthetic equipment are addressed in the critical care section above
  • instruments and devices should be decontaminated in the normal manner in accordance with manufacturers’ advice
  • both laryngoscope handle and blade should either be single use or reprocessed in the Sterile Supply Department. Video laryngoscope blades should be single use and scope/handle decontaminated as per manufacture instructions.
  • the theatre should be cleaned as per local policy for infected cases, paying particular attention to hand contact points on the anaesthetic machine
  • possible or confirmed cases of COVID-19 should be placed at the end of the list where feasible

For patients with possible or confirmed COVID-19, AGPs should only be carried out when essential. Only those healthcare staff who are needed to undertake the procedure should be present. After the patient leaves the theatre, 5 minutes should pass before staff without respirators can enter and clean.

Full guidance is available below. 

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