NEUROSURGICAL EMERGENCIES CAN’T WAIT IN COVID CRISIS

The COVID-19 pandemic has forced the healthcare system in creating the basis for an interesting new standard for the Post COVID-19 period. In these difficult times the cooperative spirit has risen spontaneously to unmet levels both from hospitals and healthcare workers. There is complete change in paradigms in treatment protocols especially in handling Neuro emergencies.

The following clinical situations have been defined as Neurosurgical emergencies-

• Cranial trauma
• Spinal trauma
• Cerebral hemorrhages (subarachnoid and intraparenchymal)
• Acute hydrocephalus
• Brain Tumors at risk of Intracranial Hypertension
• Spinal cord compressions with neurological deficit

Dealing with Neuro-oncological pathology, priority criteria have been defined: 

Neuro-oncology requiring immediate treatment: patients with intracranial or spinal oncological pathology that need emergency treatment (rapidly evolving intracranial hypertension with deteriorating state of consciousness, acute hydrocephalus, spinal cord compression with rapid tetra or paraparesis).

Neuro-oncology requiring treatment within a maximum of 7– 10 days): patients with oncological pathology (intracranial tumors with mass effect or with progressive neurological deficit, without deterioration of consciousness, spine tumors without or early neurological deficits).

We developed standardized systems of care so that a necessary and required stock of personal protective equipment (PPE) is always available and provide a seamless care to neurological patients and ensure prioritization of acutely ill neurological/neurosurgical patients even at times of limited inpatient hospital resources.

We follow a no wait policy for these situations and no patient is denied early intervention even if the patient is tested COVID positive or from containment zone or with history of contact with COVID positive patients. All patients are attended immediately in a special secluded zone in emergency department and triage is done and treatment is initiated immediately as per the need. Strict guidelines with PPE were layed to keep the patient as well as the healthcare worker safe and secure.

We truly hope that the COVID-19 outbreak will soon end in our beloved country and may never experience such a tragic emergency.