Sharing Our Experience of Operating an Endoscopy Unit in the Midst of a COVID-19 Outbreak

Han, Jimin; Kim, Eun Young

When the endoscopy unit was reopened after being disinfected for two days, only a limited number of endoscopic procedures could be performed with the help of nurses from our health promotion center. Because an airborne infection isolation (negative pressure) room is not available in this endoscopy unit, the only one room with windows that can be opened after the procedure was utilized. Indications for endoscopic procedures were redefined to include urgent situations (e.g., gastrointestinal [GI] bleeding, acute cholangitis, foreign body, luminal obstruction) and care for cancer patients (e.g., biopsy, biliary and luminal stenting). Non-urgent procedures were rescheduled to a later date. Prior to endoscopic procedures, every patient was screened and risk stratified for COVID-19 by history taking for potential exposure to infection, symptoms such as fever and coughing, and measurement of body temperature. 2,3 He/she had to wear a facial mask and could take it off immediately before starting the actual endoscopic procedure. After an endoscopic procedure under conscious sedation, the patient could wear a facial mask again only if their PaO 2 was above 95% with room air. All endoscopic exams should be considered aerosol generating procedures 3 and fecal viral RNAs have been detected in 53% of patients with COVID-19. 4 Therefore, all healthcare personnel were required to wear proper personal protection equipment (PPE) including N95 or KF94 masks, disposable plastic gowns, gloves, and eye protection with goggles or a facial shield.