Management of paediatric surgical patients during the COVID-19 pandemic: Our challenges

Journal of Paediatric Surgeons of Bangladesh Pub Date : 2024-04-23 DOI:10.3329/jpsb.v10i1.72639

Mohammed Shadrul Alam, A. Basher, Jaglul Gaffer Khan, Muhammed Moinul Huque, Tahmina Hossain, Shahnoor Islam, Samidur Rahman, K. Hasina, Abdul Tablu Hanif, A. Huq

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Abstract

Purpose: Here we describe the challenges and procedures adopted to ensure safe paediatric surgery services during the COVID-19 pandemic at the paediatric surgery department in non-Covid-19 wing of Dhaka Medical College Hospital-1. Materials and Methods: Design: Retrospective study. Setting: Department of paediatric surgery in non-Covid- 19 wing of Dhaka Medical CollegeHospital-1, a tertiary care academic medical center in Dhaka, Bangladesh. Participants and duration: All patients who were admitted in the department of paediatric surgery in Dhaka Medical College Hospital-1 from March 1 through June 30, 2020. Methods: We identified patients with or without a rRTSARS- CoV-2 PCR receiving care at the department of paediatric surgery. The healthcare professionals were trained to clean, disinfect, use of PPEs, and other wastes were disposed of as per waste management protocols. Data collection & analysis: Patient data were manually abstracted from the medical record for evaluation. Responses were analysed using Microsoft Excels & SPSS, and presented as categorical data and percentages. Main outcome measures: We describe patient characteristics including demographics, presenting symptoms, type of treatment (Surgery vs Non Surgery), outcomes (morbidity & mortality), hospital stay, and distance travelled for treatment. Results: A total of 320 paediatric surgical patients were included in this study, among all patients about 66.87% patients were male child and 79.06% patients required surgeries. There were 5 patients with confirmed COVID- 19, who were transferred to the Covid-Surgical unit. During this period, there were 4 (1.25%) children who died due to non-COVID related causes. In surgical group only 24(7.5%) patients developed postoperative complications. Length of hospital stay of 44 (13.75%) of non-surgical patients were less than 72 hours, whereas 141 (40.06%) of surgical patients were more than 72 hours. Majority of patients of both groups travelled more than 100 km distance for treatment. Conclusions: This corona crisis has provided an opening for rational health care and formulating global policies. So that in future such pandemics can be tackled more carefully and consistently with advancing knowledge and better preparation. Journal of Paediatric Surgeons of Bangladesh (2019) Vol. 10 (1 & 2): 15-21

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在 COVID-19 大流行期间对儿科外科病人的管理：我们面临的挑战

目的：我们在此描述达卡医学院第一医院（Dhaka Medical College Hospital-1）非Covid-19翼儿科手术部在COVID-19大流行期间为确保安全的儿科手术服务所面临的挑战和采取的程序。材料与方法：设计：回顾性研究。地点孟加拉国达卡医学院第一医院（Dhaka Medical CollegeHospital-1）非Covid-19翼儿科手术部，该医院是孟加拉国达卡的一家三级医疗学术中心。参与者和持续时间：2020年3月1日至6月30日期间达卡医学院第一医院小儿外科收治的所有患者。研究方法我们确定了在儿科手术部接受治疗的患有或未患有 rRTSARS- CoV-2 PCR 的患者。对医护人员进行了清洁、消毒和使用个人防护设备的培训，并按照废物管理规程处理其他废物。数据收集与分析：人工从病历中抽取患者数据进行评估。使用 Microsoft Excels 和 SPSS 对数据进行分析，并以分类数据和百分比的形式呈现。主要结果测量：我们描述了患者的特征，包括人口统计学、主要症状、治疗类型（手术与非手术）、治疗结果（发病率与死亡率）、住院时间以及治疗距离。结果：本研究共纳入了 320 名儿科手术患者，其中约 66.87% 的患者为男性，79.06% 的患者需要进行手术。有 5 名确诊为 COVID- 19 的患者被转到了 Covid 外科病房。在此期间，有 4 名（1.25%）儿童死于与 COVID 无关的原因。手术组中只有 24 名（7.5%）患者出现术后并发症。44 名（13.75%）非手术患者的住院时间少于 72 小时，而 141 名（40.06%）手术患者的住院时间超过 72 小时。两组患者中的大多数人都前往 100 公里以外的地方接受治疗。结论：这次日冕危机为合理的医疗保健和制定全球政策提供了契机。孟加拉国儿科外科医生杂志》（2019 年）第 10 卷（1 & 2）：15-21

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Journal of Paediatric Surgeons of Bangladesh

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