Anesthesia Considerations & Precautions 7.17.20

Gary E. Loyd, MD, MMM

Director of Perioperative Surgical Home

Henry Ford Health System

Clinical Professor, Wayne State University

Anesthesia Considerations &

Precautions for Ramp Up of

Operations following COVID 19

Peak Pandemic

No Conflicts of Interest

Learning Objectives

 By the end of the presentation, the

learners should be able to:

– Grasp the challenges of operating in a new

CoVid consciousness

– Understand the logistics of ramping up in a

post crisis situation

– Navigating the human factors of post-peak

CoVid

Challenges of Operating in a New

CoVid Consciousness

 8,000 case backlog

 Infrastructure barriers

 New CoVid testing policies

 Positive vs Negative Pressure ORs

 Machine filters and protection

 Induction and Intubating policies

 PPE supplies

 Transport policies

Logistics of Ramping Up

 Estimating staffing needs for hospital ORs

 Undeploying redeployed medical and

nursing staff

 Unfurloughing support staff

 Navigating CoVid testing and precautions

 High turnover times

 New inpt-to-OR workflows

 Mass migration to ASCs

Navigating the Human Factors

 Patients’ reticence

 Medical and nursing staff PTSD

 Fear factors

 Push-back and scrutiny on new policies

 Cautious workflows

 Patient testing refusals

 Virtual meeting fatigue

Summary

 Challenges

– Structural

– Operational

 Logistics

– Backlog of cases

– Aligning people with work

 Human Factors

– Fear

– PTSD