During the COVID-19 pandemic, the American College of Surgeons issued new surgical triage guidance on surgical decision taking to limit elective surgical procedures and conserve the resources available and care for critically ill patients.
Titled “COVID-19: Elective Case Triage Guidelines for Surgical Care,” the guidelines were established in multiple specialties after an expert review to include reliable guidance from the most recent, best available data, as per a press release. The release noted that the triage guidelines should be used in combination with a joint recommendation from the ACS, American Society of Anesthesiologists and the Association of PeriOperative Registered Nurses and medical centers should establish a Surgical Review Committee to serve as an administrative body to provide established, open and sensitive oversight for the trial of surgical cases.
In its recommendations, the ACS recommends surgeons, whenever clinically appropriate, should accept non-operative management. The ACS noted effective and timely surgical treatment should be focused on sound surgical judgment and resource accessibility, and emergency surgical procedures should be avoided at night, due to reduced team resources whenever possible. Surgeons should also wait for results of COVID-19 tests in patients that may be contaminated, and aerosol-generating procedures should not be done without wearing full personal protective equipment like a N95 mask or activated, air-purifying respirator equipped for OR.