Covid-19 test on kids before anaesthesia saves PPE: Study

Universal Covid-19 testing of children undergoing procedures requiring anaesthesia promotes efficient use of personal protective equipment (PPE), say researchers.

“Our study links the importance of universal testing for Covid-19, increased safety of staff, and efficient use of PPE, especially items such as N95 face masks, which are in low supply,” said study lead author Lenard Babus from Children’s Hospital of Philadelphia in the US.

“If universal testing were used outside the hospital, outpatient facilities and other treatment centres could experience similar PPE and safety benefits,” Babus added.

Ruling out that Covid-19 prevents unnecessary use of the extensive PPE recommended by the Centres for Disease Control and Prevention (CDC).

CDC-recommended PPE for treating Covid-19 positive patients includes a respirator mask, such as an N95 or PAPR, and a gown, in addition to the standard PPE of a surgical mask, eye protection and gloves, which are always worn by healthcare workers during procedures requiring anaesthesia.

Hospitals frequently verbally screen patients for Covid-19 using three criteria: travel history, close contact or exposure to the disease, and symptoms such as fever, cough or shortness of breath.

However, a positive screen doesn’t guarantee the presence of Covid-19.

Conversely, a patient may have no symptoms of the virus or apparent risk for Covid-19, but may still have the virus.

For the study, researchers analysed results of Covid-19 testing in anaesthesia procedures performed at the Children’s Hospital of Philadelphia between March 26 and May 11, 2020.

Patients required anaesthesia for a wide range of procedures, from MRI to cancer surgery and appendix removal.

All children were tested for COVID-19 using the polymerase chain reaction (PCR) test prior to receiving anaesthesia. They then compared the test results to those who were suspected of being infected, based on the verbal screening method.

Overall, 1,033 children were included in the study and 146 children verbally screened positive for at least one of the three criteria.

Without Covid-19 PCR testing, healthcare providers treating all 146 children would have been required to wear expanded PPE, including an N95 mask or respirator. However, because their Covid-19 PCR test was negative, 102 of the 146 patients received care with standard PPE, a reduction of 70 per cent.

They also found that 10 children who were verbally screened negative for the disease actually tested positive for Covid-19, and may have otherwise been overlooked, increasing healthcare workers’ risk of exposure.

The study is scheduled to be presented at the ANESTHESIOLOGY 2020 annual meeting to be held between October 2-5 this year.