The American College of Surgeons has posted a recommended surgical protocol for possible or confirmed Ebola cases on the Ebola virus transmission resource page. The protocol was developed by Dr. Sherry M. Wren, F.A.C.S., and Dr. Adam L. Kushner, M.P.H., F.A.C.S.
“Elective surgical procedures should not be performed in cases of suspected or confirmed Ebola. In cases where an emergency operation must be performed this protocol should be implemented to minimize risk to hospital personnel. The choice of operative approach (open or [minimally invasive surgery]) should take into consideration minimizing potential hazards to all members of the OR team,” according to the protocol.
The document continues, “Although protocols for personal protective equipment (PPE) are in place to protect health care workers, there is no guideline for operating room personnel and surgical providers who might need to perform an operation on a patient with confirmed or suspected Ebola infection, therefore we have adapted relevant Centers for Disease Control recommendations and apply them specifically to the OR environment.”
Dr. David B. Hoyt, F.A.C.S., executive director of ACS, explains that, “the College, like other societies and various governmental entities, wants to do its part to share resources that may be helpful to the medical community and patients in the face of an emerging presence of Ebola, including this surgical protocol. It is important to emphasize, though, that what we learn about transmission, treatment, and protection will continue to evolve. Ultimately, I think all of us who are disseminating this and various other resources recognize that evidence-based guidelines will ultimately emerge. Until then we must be proactive in sharing even early recommendations from credible sources.”
The resource page provides news, health care organization links, and other helpful information about Ebola. In addition, some guidance on surgical protocols is listed, including an overview of patient transport or transfer to the OR, a surgical checklist, protective equipment and draping, and special instrument requirements. A brief directive on how to handle cases of possible exposure of medical staff also is provided.
The ACS resource page will be updated as new information becomes available.