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Transmissible Infections


What is MERS-CoV and what precautions should be taken for suspected or confirmed cases in the perioperative setting?

Answer:

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a respiratory illness caused by coronavirus. It was first reported in Saudi Arabia in 2012 and has since spread to several other countries, including the United States. Most patients with MERS-CoV have developed severe acute respiratory illness with symptoms of fever, cough and shortness of breath. Healthcare providers should evaluate patients for MERS-CoV infection according to CDC recommendations. Guidance from the CDC on MERS is rapidly evolving due to the current lack of a safe and effective vaccine and chemoprophylaxis, a possible high rate of morbidity and mortality among infected patients, and incompletely defined modes of transmission of MERS-CoV.

Because MERS-CoV affects the respiratory system, surgical interventions are not typically indicated for treatment. Elective surgery for patients with suspected or confirmed MERS-CoV should be decided on a case-by-case basis by the provider and local health department. Preoperative screening should include:

  • fever  
  • symptoms of respiratory illness (eg, pneumonia, ARDS, cough, shortness of breath) 
  • close contact with a confirmed MERS case while the case was ill 
  • travel within 14 days to countries with ongoing MERS-CoV transmission (eg, Arabian Peninsula: Bahrain, Iran, Israel, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, the United Arab Emirates, and Yemen; Republic of Korea) 

Perioperative team members caring for patients with MERS-CoV should follow standard, contact, and airborne precautions (eg, gown, gloves, N95 respirator, and eye protection).

Resources

Updated June 16, 2015 

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Do observers in the OR have to meet immunization requirements?

Answer:

Yes, observers of operative or other invasive procedures (eg, students, visiting physicians) should be immunized according to the health care organization's policy for healthcare personnel.

Resources

  • Wood A. Immunization recommendations for perioperative observers. [Clinical Issues]. AORN J. 2013;97(5):587-589.

Updated August 7, 2013 

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Do prescription eye glasses provide adequate eye protection for scrubbed team members?

Answer:

Standard prescription eye glasses are not considered eye protection by the CDC. Appropriate eye protection should fit snug on the brow and have solid side shields, in addition to having anti-fog properties. A face shield may also be worn to protect the eyes and face from splash or splatter.

Resources

  • Ogg M. Types of acceptable eye protection. [Clinical Issues]. AORN J. 2013;98(2):195-196.

Updated August 7, 2013 

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