My interest is in how this epidemic influenced the approach to our patients. New rules are now changing also the behavior of medical staff. I would like to have a focus on:
- management of outpatient visits
- management of hospitalizations
- management of operating rooms
Feel free to tell me your experience, it could be useful for the next countries touched by the Virus.
Dear Dr Francesco Maffia
Certainly, the rules must change, Many of my colleagues have closed their private clinics due to fear from the virus, but somebody has to treat people especially those that have emergencies like pulpitis with either extraction or root canals. Sterilization is mandatory with autoclaves, use of disinfectants for floors sodium hypochlorite for instruments. dentists should also wear masks, shields in addition to gloves and special disposable gowns, there are some dentists that even take the patients temperature as an indicator of having the virus.
Dear Dr Francesco Maffia
Certainly, the rules must change, Many of my colleagues have closed their private clinics due to fear from the virus, but somebody has to treat people especially those that have emergencies like pulpitis with either extraction or root canals. Sterilization is mandatory with autoclaves, use of disinfectants for floors sodium hypochlorite for instruments. dentists should also wear masks, shields in addition to gloves and special disposable gowns, there are some dentists that even take the patients temperature as an indicator of having the virus.
Dear Dr Raia Al-Naimi,
Thank you for your contribute. If you want, share this question with some of your colleagues.
Best regards
Dear Dr Francesco Maffia
Just for emergency treatment.
The infection control is the most important part to eliminate the spread of COVID-19.
Singapore has classify the Covid level to 4 responses. We are at DORSCON orange(or level 3). The following are plans:
1. outpatients,. All procedures that generates aerosols required N95/FFP2 Mask and AAMI level 4 gowns. Patients are to be seated at least 2 meters apart. All patients with symptoms(temperature/cough/SOB) and history are diverted to emergency. Otherwise they are sent home for quarantine
2. All elective surgeries are deferred. Should there be urgent/emergency cases, PPE according to the above are necessary. If a confirmed case is seen, respirators and PPE is mandatory
3.OTs. all keyboards, items are wrapped and suctions are at its most powerful. Ideally there should be unilamellar air flow. at the end of the day, all OTS are wiped down with milton solition or bleach.
HOpe the above helps
The social distancing policy is making it impossible to conduct appropriate consultation and clinical examination of patient hence diagnosis & treatment outcomes unpredictable.
Dear Dr. Maffia,
The Outpatient Clinic of the OMFS Dept. of National and Kapodistrian University of Athens Dental School at the University Campus has closed, and all emergencies are sent to the "Evangelismos" General Hospital of Athens-OMFS Dept. of National and Kapodistrian University of Athens Dental School. At both private hospitals I am offering my services ("Metropolitan Hospital": Assoc. Director, OMFS Dept., and "Eugenideio Hospital-The Holy Trinity SA": External Partner-Clinical Associate), all elective surgeries are postponed and only emergencies (craniomaxillofacial trauma, cervicofacial infections etc.), and oncological (oral, head & neck cancer) patients are treated. The same applies to my private practice as well.
Experience from India:
Though I'm not clinic Dentistry, but all of my colleagues/Juniors have confirmed:
1. Patient flow have increased since people are home
2. Following the association's guidelines, Dentists have stopped taking any new non-emergency patients. Though some of them are following up their non-emergency old patients.
Some of my recommendations:
Consider every patient coming to your clinic as a carrier of Corona Virus.
Don't let people to cluster/accumulate in waiting area
Disinfect the entire clinic, at least 2 times a day
We have stopped elective appointments and only providing emergency Ot for trauma, infections or cancer. General oral surgery procedures have been cancelled and patients are advised to stay at home for minor complaints and only visit hospital if emergency. Thermal scanning at entry ports of hospital are in place and patients with suspicious history and fever are diverted to fever clinic and isolated fever ward. We are using eye protection, Disposable gowns and double masks if we need to go to OT and ward. Rotary duty has been started to reduce exposure to all the physician at same time.
Dear maxillofacial colleagues and friends,
We are sending you a survey to know how’s everything going on in your country and in your practice. This project is supported by Prof Cascone (Rome, Italy) and Prof Mercuri (Chicago, USA). It won’t take more than 5-10 minutes.
Francesco Maffia, Marco Fontanari
Survey link: https://forms.gle/M6n7sjXu9AKAMsr79
In my city no COVID-19 infection but i take care with any surgical cases by using potent antiseptics containing alcohol ,with patient of history for better immunity systems.
Elective procedures should be delayed
Only emergencies should be treated with extreme precautions considering every patient as carrier.which is beneficial for both staff and patients
As others say, infection control and protection are mandatory to prevent spread of the infection. Emergency cases can be treated under restrictive protection rules. The biggest problem is that there is no definitive treatment and vaccine for this out break pandemic infection.
Dear Colleagues,
Our paper is out:
https://www.ijoms.com/article/S0901-5027(20)30160-0/fulltext
As others say; Only emergencies should be treated with extreme precautions considering every patient as carrier. which is beneficial for both staff and patients.We have restristive protection rules. The biggest matter is that , the protective material is limited. Buy it now is to difficult and expensive.