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Researchers unveiled new guidance Wednesday for treating patients who have strokes amid the COVID-19 pandemic as a way to protect health care workers and allocate limited resources.
The new guidance has four phases: pre-hospital to the emergency department, pre-thrombectomy procedure, thrombectomy intra-procedure and post-reperfusion therapy. These procedures have taken on a heightened risk for health workers due to the possible transmission of the new coronavirus.
“Every opportunity and detail to recalibrate our acute neurological workflow to protect our frontline health care workers, our families, our colleagues and our patients should be sought, implemented and adapted to a resource-constrained environment,” corresponding author Thanh Nguyen, professor of neurology, neurosurgery and radiology at Boston University School of Medicine (BUSM) and director of the neuroendovascular service at Boston Medical Center, said in a statement.
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One of the recommendations asks doctors to consider conscious sedation as the first line to protect anesthesiologists from exposure and to protect patients from unnecessary intubation, as well as to conserve mechanical ventilator resources.
If patients exhibit pulmonary symptoms, doctors are advised to lower the threshold to intubate patients in a controlled manner in a negative pressure room.
The guidance also suggests using remote tele-stroke technology to obtain patient history and perform a neurological examination, post-reperfusion monitoring, if that’s possible.
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As of Wednesday afternoon, there were at least 3,173,036 people infected with COVID-19 worldwide, and the disease has killed at least 225,927 others.
The guidance was developed by a team from the Society of Vascular & Interventional Neurology (SVIN) and led by a BUSM researcher.