COVID 19 PANDEMIC 2020 – INTRAOPERATIVE NEUROMONITORING PRACTICE RECOMMENDATIONS
HOW DOES THE COVID-19 PANDEMIC AFFECT THE PRACTICE AND DEVELOPMENT OF INTRAOPERATIVE NEUROPHYSIOLOGY?
We live in a time of uncertainty and fear, and sometimes it seems that all our medical knowledge is not useful enough. We are facing something completely new, and we do not know the myriad of clinical presentations, the treatment, the prognosis. These reasons explain why we feel insecure.
There is scarce literature, and the information is sometimes confusing. The most trustable source of data is the experience of the people in the field.
At least three immediate consequences have had the pandemic on the practice of intraoperative neurophysiology; a) A dramatic drop in the number of cases to be monitored, b) Rapid implementation of the protective measures (personal protective equipment) to neuromonitoring in a potential viral environment and c) Cancellation of all the live educational and academic activities, like courses and congresses.
The reasons that explain the significant drop in the number of cases to be monitored are mainly the following:
Almost all healthcare facilities mandated to focus on COVID -19 patient care and postponed all elective surgeries unless there is an absolute necessity. Patients are also reluctant to undergo any elective surgery under the threat of COVID -19 infection. There are reports that even asymptomatic COVID-19 infection increases the risk of surgery. From the perspective of IONM, skull base surgeries might be at the highest likelihood to be exposed to COVID-19.
The current situation during the pandemic has some real risks because there are well known medical conditions that cannot hold on for a long time. Preliminary reporting suggests that there are adverse effects on morbidity and mortality of those diseases. (Vandoros S, Excess mortality during the COVID -19 pandemic: Early evidence from England and Wales; Social Science & Medicine 258, August 2020 https://doi.org/10.1016/j.socscimed.2020.113101)
In these very challenging times, ISIN would like to deliver practical advice and educational support.
You are invited to send your question to us about IOM Practice issues in Covid-19 patients; we will try to answer your concerns.
Pneumonia epidemic of unknown cause occurred in Wuhan, China, in December 2019. The agent of this pneumonia was identified as a novel coronavirus that was initially named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease related to it as coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). And it was declared as a pandemic disease on March 11, 2020.