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. 2020 Jul;78(7):1136-1146.
doi: 10.1016/j.joms.2020.04.034. Epub 2020 Apr 28.

Evolution of COVID-19 Guidelines for University of Washington Oral and Maxillofacial Surgery Patient Care

Kanvar Panesar  1 , Thomas Dodson  2 , John Lynch  3 , Chloe Bryson-Cahn  4 , Lisa Chew  5 , Jasjit Dillon  6
Affiliations

Evolution of COVID-19 Guidelines for University of Washington Oral and Maxillofacial Surgery Patient Care

Kanvar Panesar et al. J Oral Maxillofac Surg. 2020 Jul.

Abstract

The emergence of coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 (SC2) virus, in late December 2019 has placed an overwhelming strain on healthcare institutions nationwide. The modern healthcare system has never managed a pandemic of this magnitude, the ramifications of which will undoubtedly lead to lasting changes in policy and protocol development for viral testing guidelines, personal protective equipment (PPE), surgical scheduling, and residency education and training. The State of Washington had the first reported case and death related to COVID-19 in the United States. Oral and maxillofacial surgeons have a unique risk of exposure to SC2 and developing COVID-19 because of our proximity of working in and around the oropharynx and nasopharynx. The present report has summarized the evolution of COVID-19 guidelines in 4 key areas: 1) preoperative SC2 testing; 2) PPE stewardship; 3) surgical scheduling guidelines; and 4) resident education and training for oral and maxillofacial surgery at the University of Washington, Seattle, Washington.

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Figures

Figure 1
Figure 1
Initial University of Washington School of Medicine preoperative coronavirus disease 2019 (COVID-19) testing algorithm. OR, operating room; PAPR, powered air purifying respirator; PPE, personal protective equipment.
Figure 2
Figure 2
University of Washington School of Medicine (UW Medicine) coronavirus disease 2019 (COVID-19) testing approach for A, inpatients and B, asymptomatic patients assessed in clinics. AGP, aerosol-generating procedure; BiPAP, bilevel positive airway pressure; CPAP, continuous positive airway pressure; c/w, consistent with; ENT, ear, nose, and throat; F/U, follow-up; HMC, Harborview Medical Center; OMFS, oral and maxillofacial surgery; OPMC, outpatient medical center; OR, operating room; NP, nasopharynx; Pre-op, preoperative; RN, registered nurse; sxs, symptoms; TEE, transesophageal echocardiography; trach, tracheal; UWMC, University of Washington Medical Center.
Figure 2
Figure 2
University of Washington School of Medicine (UW Medicine) coronavirus disease 2019 (COVID-19) testing approach for A, inpatients and B, asymptomatic patients assessed in clinics. AGP, aerosol-generating procedure; BiPAP, bilevel positive airway pressure; CPAP, continuous positive airway pressure; c/w, consistent with; ENT, ear, nose, and throat; F/U, follow-up; HMC, Harborview Medical Center; OMFS, oral and maxillofacial surgery; OPMC, outpatient medical center; OR, operating room; NP, nasopharynx; Pre-op, preoperative; RN, registered nurse; sxs, symptoms; TEE, transesophageal echocardiography; trach, tracheal; UWMC, University of Washington Medical Center.
Figure 3
Figure 3
University of Washington (UW) personal protective equipment (PPE) algorithm. BiPAP, bilevel positive airway pressure; COVID-19, coronavirus disease 2019; CPAP, continuous positive airway pressure; HMC, Harborview Medical Center; PAPR, powered air purifying respirator; UWMC, University of Washington Medical Center.
Figure 4
Figure 4
Comparison of mask levels, indications, and filtration effectiveness. ASTM, American Society for Testing and Materials; BFE, bacterial filtration efficiency; PFE, particle filtration efficiency.
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