Modification of Neurosurgical Practice during Corona Pandemic: Our Experience at AIIMS Patna And Long Term Guidelines

Singh Saraj, K.; Mishra Vishal, A.; Jha Vikas, C.

BACKGROUND: First case of covid-19 was confirmed on 30(th) January, 2020 in India. Our state, Bihar reported its first confirmed case of covid on 22(nd) march 2020 at AIIMS Patna. For safety, Electives surgeries and outpatient department was suspended temporary since 25(th) March. Standard operating procedure (SOP) was framed for covid suspected, covid positive and negative patients. Neurosurgery department formulated their own strategy for successful and covid free management of neurosurgical patients along with zero transmission rate among doctors and staff. METHODS: All Neurosurgical patients who got attended, admitted and operated from 25(th) March to 30(th) June 2020 (Period of lockdown) were taken in this study. Categorizations of the patients were done according to the urgency and elective nature of pathology after corona screening and RT-PCR testing of covid-19. A proper training to all neurosurgical staff and residents were given for management of patients (admission to operation to discharge). RESULTS: Total 133 patients were attended and 90 were admitted. We operated 76 cases (major -52, minor – 24) during the lockdown period. Out of this 2 were corona positive (both eventually succumbed) and rest 74 was corona negative. One patient who was operated with corona negative report became positive after 10 days of surgery inward. All the residents, faculty and nursing staff remain asymptomatic throughout the lockdown period with zero infection rate and zero transmission rate. CONCLUSION: Following a properly made standard operating procedure and strictly implementing it can avoid any type of misadventure in neurosurgery during corona pandemic. KEY MESSAGE: Adequate planning and sufficient training is necessary to avoid any untoward incident of infection. Proper utilization of limited human resources and infectious kit is needed at this time.