ALGORITHM FOR COVID-19  GUIDELINES IN TRIAGING  EMERGENCY/URGENT  ENDOSCOPY CASES

*All ELECTIVE endoscopic procedures should be SUSPENDED for now. 

** It is HIGHLY RECOMMENDED that PUIs/COVID positive patients should use a separate TOILET (especially those who had bowel preparation for colonoscopy) 

*** Proper room decontamination should be STRICTLY ADHERED TO every after procedure. 

*Malignant/non-malignant obstructions, perforations and post-OP leaks needing stenting, OVESCO and endoscopic internal drainage should be discussed thoroughly by the team depending on the alternative procedure , expertise and technology.

NOTE:

1.    All ENDOSCOPY Cases are considered as AGP (Aerosol-generating procedure). LEVEL 3 PPE is required.

(REMEMBER!!! Viable virus stays-3hrs in aerosols and 3 days in surfaces)

2.    N95 mask or facemask, goggles/glasses/gloves) are REQUIRED for low-risk exposure (OPD consultation/Non-COVID exposure

SOURCES:

1.    PCS Recommendations for the rational and effective use of PPE: guidelines for extended use, re-use and acceptable reprocessing methods 

2.    Soetiko, et al. 2020. Considerations in performing endoscopy during the COVID-19 pandemic. 

3.    ASGE Joint GI Society Message: COVID-19 Clinical Insights for Our Community of Gastroenterologists and Gastroenterology Care Providers 

4.    SAGES Regarding Surgical Response to COVID-19 Crisis 

5.    CDC’s Interim US Guidance for Risk Assessment and Public Health Management of Healthcare personnel with Potential Exposure to in a Healthcare setting to patients with COVID-19 

6.    American College of Surgeons: COVID-19 and Surgery 

7.    ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic 

8.    Yafei, et al. 2020. Suggestions of Infection Prevention and Control in Digestive Endoscopy During Current 2019-nCOV Pneumonia Outbreak in Wuhan, Hubei Province, China 

9.    Tokyo Guidelines on Acute Cholangitis 2018 

10.    ASGE Guidelines on Management of Choledocholithiasis

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