Surgery triage during the COVID-19 pandemic

Area of Science:

• Public Health
• Surgical Management
• Infectious Disease Epidemiology

Background:

• The COVID-19 pandemic necessitated emergency responses, including hospital resource management.
• Surgical triage was crucial for maintaining healthcare system capacity during the pandemic.
• Governments in Australia and New Zealand activated emergency plans to manage potential resource strain.

Purpose of the Study:

• To review evidence and expert advice on surgical triage during the COVID-19 pandemic.
• To summarize recommendations for managing surgical caseloads amidst the pandemic.
• To inform clinical judgment and patient-centered care in surgical decision-making.

Main Methods:

• A rapid review methodology was employed, searching PubMed and grey literature.
• Searches were supplemented by information from the Royal Australasian College of Surgeons COVID-19 Working Group.
• Recent government advice from May 2020 was incorporated into the review.

Main Results:

• Key theme: maintain clinical judgment for individualized, ethical, patient-centered surgical care.
• Addressed implications of COVID-19 on surgical triage and resource allocation.
• Noted that low COVID-19 incidence may allow for gradual increase in surgical caseloads.

Conclusions:

• Urgent and emergency surgery must continue during the COVID-19 pandemic.
• Elective surgery should resume in stages, aligned with declining COVID-19 caseloads.
• Schemas and recommendations were developed for surgical triage in Australia and New Zealand.