Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
Abstract
Abstracts
Brief Communication
Case Report
Case Series
Commentary
Conference Abstract
Conference Editorial
Conference Proceedings
Current Issue
Editorial
Editorial Commentary
Erratum
IAPCONKochi 2019 Conference Proceedings
Letter to Editor
Letter to the Editor
Letters to Editor
Narrative Review
Original Article
Personal Reflection
Perspective
Perspectives
Position Paper
Position Statement
Practitioner Section
Report
REPUBLICATION: Special Article (Guidelines)
Review Article
Short Communication
Special Editorial
Special Review
Systematic Review
View/Download PDF

Translate this page into:

Letters to Editor
26 (
Suppl 1
); S183-S184
doi:
10.4103/IJPC.IJPC_171_20

Considerations for palliative intervention procedures in the COVID pandemic

Department of Oncoanesthesia and Palliative Medicine, AIIMS, New Delhi, India
Department of Medical Oncology, Dr. BRA-IRCH, AIIMS, New Delhi, India
Address for correspondence: Dr. Sapna Singla, 838, Sector 15, Part 2, Gurgaon - 122 001, Haryana, India. E-mail: sapnasingla08@gmail.com
Licence

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Disclaimer:
This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher; therefore Scientific Scholar has no control over the quality or content of this article.

Sir,

Cancer patients seek palliative care services for pain management and alleviation of various symptoms. To deliver prudent palliative care services, various procedures and interventions such as nerve blocks, neurolysis, pleurocentesis, paracentesis, and various image-guided procedures are being performed. When the whole medical system has been paralyzed by the COVID-19 pandemic, the availability and provision of these facilities has become challenging and prioritization should be done to utilize them judiciously.

As COVID-19 is hazardous for the health service provider as well as the seeker, all patients should be considered COVID-19 suspect and should be screened as per institutional guidelines before admission and performing any procedure. In wards, measures should be taken to avoid the transmission of infection to other patients and health-care provider. A screening area should be established at the entrance of institution along with a separate exit area. All health-care providers should be well trained for symptom recognition, screening procedures, and use of standard precautions and personal protective equipment. To avoid potential paper contamination, various documentations, such as clinical and procedural notes, consents, and nursing records, should be digitalized and protected with single-use plastic wraps.[1]

A dedicated area should be established for performing procedures with a designated route of transport, to avoid cross contamination. A well-formulated plan for its decontamination and disinfection should be followed. During procedures, health-care providers should wear protective gears and patients should also wear surgical mask.[2] Only necessary personnel, drugs, and equipment should be allowed in the procedural areas.[34] Equipment such as ultrasound machine used for performing various procedures can be a potential source of transmission of COVID-19 infection. For decontamination of equipment and disinfection of clinical area, institutional guidelines should be followed.[5]

Postprocedural management and observation for complications should be done in the same designated area. Patients should be discharged from the same area along with the advice of general precautionary measures and follow-up plan. Patients should be educated about telemedicine and should be advised to follow it for minor concerns so that their hospital visits could be minimized.

With the above said, challenges to deliver palliative care efficiently can be met prudently, along with the avoidance of exhaustion of health-care system and provider.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

REFERENCES

  1. , , , , , . Practical considerations for performing regional anesthesia: Lessons learned from the COVID-19 pandemic. Can J Anaesth. 2020;67:885-92.
    [Google Scholar]
  2. Coronavirus Disease 2019 (COVID-19)
  3. , , , , , . Infection control measures for operative procedures in severe acute respiratory syndrome-related patients. Anesthesiology. 2004;100:1394-8.
    [Google Scholar]
  4. , , , , . Infection control and anesthesia: Lessons learned from the Toronto SARS outbreak. Can J Anaesth. 2003;50:989-97.
    [Google Scholar]
  5. , , , , , , . Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. 2020;323:1610-12.
    [Google Scholar]
Show Sections