It goes without saying that just about every facet of our lives has been altered since the outbreak of the novel coronavirus. For surgical neurophysiologists whose daily job involves travelling to hospitals to perform neuromonitoring during surgeries, changes are especially evident when navigating to the operating room of those facilities on the front line in the battle against COVID-19.
The roads leading to hospitals give the first hint of this new equilibrium. Traffic is basically non-existent and parking lots are nearly empty. Entering the main lobbies, you now commonly see health workers screening guests: taking temperatures, asking about any prior travel or potential exposure to the virus and, confirming that there have been no recent symptoms that would suggest illness. Almost everyone entering facilities are wearing masks.
The usual steps to obtain a vendor badge or scrubs have remained the same, but after making your way to the OR, you are struck by a largely empty board listing the day’s surgical cases. While they would normally be coordinating logistics for heavy caseloads, hospital staff is now handing out PPE. It’s not uncommon to be given a single mask that must be used for the remainder of the day to conserve these all-important supplies.
Obtaining patient consent for neuromonitoring is now completed while wearing a mask and it is not uncommon for OR staff to request that you store your bags in a new location (or cover them with a garbage bag) to prevent the spread of the virus from any outside contamination or from travel between other facilities. Setting up the room for a case remains the same, but the atmosphere is much more subdued. To keep spirits up, staff members are trying hard to engage in normal banter.
When the patient enters the OR before the start of surgery, most facilities are asking all staff, other than the anesthesiologist or CRNA, to leave the room during intubation and extubation. Many are even placing plastic coverings over the patient during extubation or using other intubation techniques to help limit the amount of aerosol in the room.
After a case is completed and a considerable amount of disinfecting agents has been used, exit from the OR is much like arrival. Changing out of OR scrubs is done quickly and quietly and a liberal amount of hand sanitizer is used after bags are packed. Masks are left on until you have safely returned to your vehicle.
What has not changed is the reason why we all continue to go to the OR. Even during these difficult times, there are patients who will require non-elective surgeries due to trauma or emergencies. As a surgical neurophysiologist, it is our job to facilitate safe and successful completion of these procedures.
As for me, I’m grateful to be away from the worst of it. I’m glad that normal OR protocols and PPE are helping to provide measures of safety and how those efforts mean all the more in times like these. Even though I know upon entering a facility that things will not be quite as easy, I am overwhelmed by the countless healthcare workers that working directly on COVID-19 units every single day. Those caregivers have my utmost respect and my sincere admiration.
Sean Greene, CNIM