The American Gastroenterological Association and the Digestive Health Physicians Association have drafted guidance for gastroenterologists to restart elective endoscopy procedures during the COVID-19 pandemic.
Eight things to know:
1. Endoscopy centers can resume elective procedures once the new COVID-19 diagnosis rate plateaus for at least 14 days, and federal, state and/or local authorities allow healthcare facilities to reopen.
2. Centers should reschedule patients by level of urgency.
3. All patients should receive a PCR-based test for an active COVID-19 infection within 48 hours of a procedure. If a center cannot screen a patient for COVID-19 preprocedure, clinicians should have the patient keep a daily temperature log for 10 days before the procedure and administer a symptom questionnaire and temperature check the day of the procedure.
4. Centers should screen employee temperatures and survey staff daily for COVID-19 symptoms.
5. Centers should enforce strict social-distancing policies including:
- Having all employees wear masks
- Spacing out intake and recovery beds as well as waiting room chairs
- Restricting patient visitors
- Requiring patients and visitors to wear masks
- Staggering procedure starting times
- Creating individual work stations for employees
- Organizing the workflow to prevent cross-contamination
6. Clinical employees should don full personal protective equipment.
7. Endoscopes should be reprocessed and then manually cleaned, followed by high-level disinfection
8. For upper endoscopy patients, centers should avoid routine endotracheal intubation and should instead consider using supplemental oxygen delivered by mask.