Guidelines for resuming elective endoscopy surgeries amid pandemic

The American Gastroenterological Association and the Digestive Health Physicians Association have drafted guidance for gastroenterologists to restart elective endoscopy procedures during the COVID-19 pandemic.

Eight things to know:

1. Endoscopy centers can resume elective procedures once the new COVID-19 diagnosis rate plateaus for at least 14 days, and federal, state and/or local authorities allow healthcare facilities to reopen.

2. Centers should reschedule patients by level of urgency.

3. All patients should receive a PCR-based test for an active COVID-19 infection within 48 hours of a procedure. If a center cannot screen a patient for COVID-19 preprocedure, clinicians should have the patient keep a daily temperature log for 10 days before the procedure and administer a symptom questionnaire and temperature check the day of the procedure.

4. Centers should screen employee temperatures and survey staff daily for COVID-19 symptoms.

5. Centers should enforce strict social-distancing policies including:

  • Having all employees wear masks
  • Spacing out intake and recovery beds as well as waiting room chairs
  • Restricting patient visitors
  • Requiring patients and visitors to wear masks
  • Staggering procedure starting times
  • Creating individual work stations for employees
  • Organizing the workflow to prevent cross-contamination

6. Clinical employees should don full personal protective equipment.

7. Endoscopes should be reprocessed and then manually cleaned, followed by high-level disinfection

8. For upper endoscopy patients, centers should avoid routine endotracheal intubation and should instead consider using supplemental oxygen delivered by mask.

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