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