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I am an anaesthetist, patients of endoscopy department are ambulatory patients, they dont want to wait the test results, is the pcr test necessary for these patients before the endoscopy procedures

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  • What is the current situation in your country? Is there uncontrolled community transmission? May 14 '20 at 6:52
  • @GrahamChiu: my guess would be Turkey kuh.ku.edu.tr/tr/doctor/ozlem-ozkalayci-_1734
    – Fizz
    May 14 '20 at 11:42
  • The European societies of relevance have a position statement on the matter esge.com/assets/downloads/pdfs/general/… I've only looked at it briefly, but they don't recommend testing everyone. Instead they recommend evaluating the risk that the patient has Covid-19 first.
    – Fizz
    May 14 '20 at 11:53
  • i am from turkey, thanks for your answer May 14 '20 at 14:11
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    @Fizz actually they do recommend testing. See the risk stratification table. May 14 '20 at 23:50
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Currently Turkey has about 1600 new cases of COVID-19 daily and its pandemic curve is still exponentially rising though also flattening. There is highly likely to be ongoing community transmission of SARS-CoV-2.

The ESGE has made a number of recommendations for the European Community. This include risk stratification. One of the components of a low risk is a negative PCR test. The document goes on to describe how endoscopy is carried out, and the infection control with respect to risk stratification class of the patient noting that endoscopy is an aerosol-generating event and an infected patient will contaminate the whole endoscopy suite.

If your patients are unwilling to undergo risk stratification then sounds unacceptable and the procedure should be declined for them. Your hospital needs a set of policies and procedures in place to manage risk during this pandemic.

https://www.esge.com/assets/downloads/pdfs/general/ESGE_ESGENA_Position_Statement_gastrointestinal_endoscopy_COVID_19_pandemic.pdf

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  • Actually they don't say to decline the procedure for all high risk patients, nor to decline it if the patient declines PCR test, but they do say to limit the endoscopies for high risk patients more than for the low risk ones..., e.g. only do them in certain dedicated time slots, and to use better PPE (e.g. FFP2/3 respirator rather than surgical mask when dealing with high-risk patients [table 2.) And to use a negative pressure room if available for high-risk patients.
    – Fizz
    May 15 '20 at 4:12

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