Title Description Tags
Operating Room Flowcharts for Perioperative Management of Urgent Surgical Procedures in Suspected or Confirmed COVID-19 Patients

These flowcharts are for OR staff and should be used in conjunction with the protocol for Perioperative Management of Urgent Surgical Procedures in Suspected of Confirmed COVID-19 Patient. Flowcharts include perioperative and room setup, intraoperative, and extubation, transfer, and room cleaning. Uploaded 04.01.20

Periop Management, Anesthesia, Anesthesiology
Perioperative Services COVID-19 Response Plan

This document broadly outlines the general processes to be implemented should it become necessary to limit surgical services in response to a significant decrease in capacity due to COVID-19. Uploaded 03.24.20

Periop Management
Referring Provider Email Regarding Surgery Postponement

This document contains approved email copy that can be used to communicate to referring physicians or surgeons about the postponement of a patient surgery or non-urgent procedure due to the COVID-19 public health emergency. Uploaded 03.25.20

Periop Management, Elective Procedure, Referring Physician Email
Perioperative Team Management for COVID19 Patient

This document is the algorithm for safe transfer of COVID/PUI Level 1 Trauma patient from Emergency Department to Operating Room. Uploaded 04.01.20

Periop Management
DRH Protocol for Perioperative Management of Surgical Procedures During the COVID-19 Pandemic

This document addresses perioperative management of patients who are KNOWN or SUSPECTED (i.e. rule-out) COVID-19 positive and need urgent surgery. Patients who do not fall into those categories will continue to be managed in the usual fashion. Uploaded 04.04.20

Periop Management, Duke Regional Hospital
Guidelines for the Use of Different Models of N95 Respirators at Duke Health

N95 respirators (or PAPRs) continue to be required for direct care of patients on Airborne (e.g., tuberculosis, measles) or Special Airborne Contact (e.g., suspected or confirmed COVID infection) precautions. Additionally, CDC has updated their guidelines and now recommends healthcare workers in areas where there is moderate to substantial community transmission of COVID-19 use N95 respirators when performing procedures that are high-risk for generating aerosols, since healthcare workers in facilities with moderate to substantial community transmission are more likely to encounter asymptomatic or pre-symptomatic patients who may be COVID-19 positive. This can include patients who tested negative during their pre-procedure test, but then develop symptoms in subsequent days. To accommodate these recommendations, Duke has implemented changes in recommended PPE for staff in perioperative and procedural areas where high-risk aerosol-generating procedures are performed.

Additionally, to ensure availability of N95 respirators when needed, DUHS has deployed new models of N95s to certain care areas. Staff may notice that DUHS now supplies N95 respirators that have a valve. Staff should use the N95 respirator model that is available at their location and per instructions of their local leadership. In this document, we have answered several frequently asked questions and highlighted key features of the different types of N95 respirators in the table below. Uploaded 09.22.20

PPE, Periop Management
OR Protocol for Perioperative Management of Urgent Surgical Procedures in Suspected or Confirmed COVID-19 Patients

This document is for OR staff and addresses perioperative management of patients who are known or suspected COVID-19 positive and need urgent surgery. Patients who do not fall into those categories will continue to be managed in the usual fashion. Uploaded 08.13.20

Periop Management, Anesthesia, Anesthesiology