Interventional radiology providers in the U.S. face the possibility of treating coronavirus patients in the coming weeks as this epidemic continues to spread. Thankfully, recent experience with similar such outbreaks can provide a blueprint for practice preparation.
Experts from Singapore General Hospital recently detailed some of these lessons learned in a new editorial, published Wednesday. They believe best practices from the 2003 SARS outbreak are still “very relevant today as we get our interventional radiology service ready for this epidemic” in 2020.
“While the following measures we propose may appear strict, it is prudent to be more proactive when dealing with a novel infection,” Kun Da Zhuang wrote Feb. 26 in Cardiovascular and Interventional Radiology.
Zhuang and colleagues from the hospital’s Department of Vascular and Interventional Radiology broke their prep process down into six easy steps:
1) Segregate patients: Individuals with differing infection risks should be segregated by location, where possible, to prevent cross-infection. This includes performing procedures on isolated individuals in separate locations from others.
2) Separate staff: For radiology groups that cover multiple hospitals, segregating manpower to different sites will help to minimize any risk of cross-transmission, Zhuang and colleagues noted.
“If intra-hospital transmission occurs, segregation of staff within institutions into independent teams will be needed to prevent shutdown of the entire team should a quarantine be required,” he added.
3) Vet and prioritize: Radiologists should carefully vet and order cases to assess the infection risk and urgency of each procedure. At Singapore General Hospital, the IR team has looked to reduce its workload to allow for “ramping up” of infection control. One suggestion, they added, is continuing urgent oncologic cases while delaying elective procedures that can wait.
4) Isolate movement: Transportation of infected patients should be minimized while emphasizing the use of portable, bedside ultrasound procedures. However, transfer to designated procedural rooms may be needed in complicated cases.
5) Enhance workflows: Practices should clearly define, structure and rehearse workflows in the procedural suite so each member is clear about his or her role.
6) Strict adherence: Interventional radiologists must practice adherence to the World Health Organization’s infection control and prevention protocols, Zhuang and colleagues wrote. This includes hand hygiene and appropriate protective equipment.
With coronavirus spreading to Singapore, the researchers have now implemented these steps in their own institution. This has resulted in a “significant decrease” in patient throughput, which Zhuang calls a “necessary sacrifice to ensure the safety of our patients and staff.”
“As the epidemic unfolds, expect swift changes of hospital protocols due to ramping up of infection control measures. It is important for IR to plug into the hospital disease outbreak management team to remain responsive and aligned with hospital protocols,” the team concluded. “We are hopeful that timely and consistent implementation of these measures will prepare your IR service not just for the current but also for future infectious disease threats.”
As of Thursday, Feb. 27, the virus has spread to 47 different countries, with 82,549 confirmed cases and 2,810 deaths. Some 33,000 patients have recovered after they were infected.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.