Subarachnoid hemorrhage guidance in the era of the COVID-19 pandemic - An opinion to mitigate exposure and conserve personal protective equipment

J Stroke Cerebrovasc Dis. 2020 Sep;29(9):105010. doi: 10.1016/j.jstrokecerebrovasdis.2020.105010. Epub 2020 Jun 5.

Abstract

Aneurysmal subarachnoid hemorrhage (SAH) patients require frequent neurological examinations, neuroradiographic diagnostic testing and lengthy intensive care unit stay. Previously established SAH treatment protocols are impractical to impossible to adhere to in the current COVID-19 crisis due to the need for infection containment and shortage of critical care resources, including personal protective equipment (PPE). Centers need to adopt modified protocols to optimize SAH care and outcomes during this crisis. In this opinion piece, we assembled a multidisciplinary, multicenter team to develop and propose a modified guidance algorithm that optimizes SAH care and workflow in the era of the COVID-19 pandemic. This guidance is to be adapted to the available resources of a local institution and does not replace clinical judgment when faced with an individual patient.

Keywords: Aneurysm; COVID-19; Critical care; Endovascular; Fever; PPE; Subarachnoid hemorrhage; Vasospasm.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Algorithms
  • Betacoronavirus / pathogenicity*
  • COVID-19
  • Clinical Protocols
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / therapy*
  • Coronavirus Infections / transmission
  • Coronavirus Infections / virology
  • Critical Pathways / organization & administration*
  • Delivery of Health Care, Integrated / organization & administration*
  • Humans
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control*
  • Occupational Exposure / adverse effects
  • Occupational Exposure / prevention & control*
  • Occupational Health
  • Pandemics
  • Patient Safety
  • Personal Protective Equipment / supply & distribution*
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / therapy*
  • Pneumonia, Viral / transmission
  • Pneumonia, Viral / virology
  • Risk Factors
  • SARS-CoV-2
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / therapy*
  • Virulence
  • Workflow