ASDA Update on COVID-19 3_16_2020

(This document has been updated as of March 16, 2020)

 

The American Society of Dentist Anesthesiologists recognizes the evolving impact of the COVID-19 global pandemic.  This statement is intended to provide a framework by which our members can make decisions regarding the safety of their patients, families and colleagues.

As per the CDC guidelines, symptoms for COVID-19 infection can occur 2-14 days after exposure. These symptoms include:

1)      Fever
2)      Cough
3)      Shortness of breath

Advanced symptoms include:
1)      Difficulty breathing or shortness of breath.
2)      Persistent pain or pressure in the chest.
3)      New confusion or inability to arouse.
4)      Bluish lips or face.

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fabout%2Fsymptoms.html

Advanced stages lead to acute respiratory distress syndrome (ARDS) which requires immediate hospitalization.  Medical centers may or may not be prepared to manage the number of hospitalizations anticipated, should a larger outbreak occur in your area. 

As well, concerns about asymptomatic transmission have been reflected in multiple recent articles, along with a growing understanding that the primary intent of minimizing the spread of the virus is to reduce the number of asymptomatic carriers who may inadvertently transmit the infection to a vulnerable contact, including family members, friends, and coworkers who are older, with or without significant medical comorbidities.  

Preventative recommendations include:

1)      Social distancing.

2)      Strict hygiene practices including regular hand washing and sanitizing.
3)      Universal precautions employed in health care including gloves, mask, eye protection and unsoiled medical attire such as gowns or scrubs.
4)      Mandating that patients and family members or staff who have any of the above symptoms MUST not come to the health care facility or in contact with others.

5)      Any staff members who come in contact with an infected person must impose a 14 day self quarantine and consult their primary care physician for further action.

 

 Decision making in Anesthesiology Care:

1)      Patient with confirmed or suspected case of COVID-19 viral infection MUST not undergo a surgical or anesthesia procedure unless it is a life-saving measure.

2)      ASDA members who will be involved in such cases should follow their hospital protocols in managing patients with highly infectious pathogens.

3)      Follow the mandates of local health officials in your respective State where you practice. Be aware that some State dental boards have directed dentists to provide “emergency care only”. Please make sure your care falls under such category if your State has mandated such action. It is important to stay abreast of changes and messages issued by healthcare authorities as the situation unfolds in your area.

4)      As the outbreak has spread, other countries have proceeded with a complete suspension of any non-emergency patient care operations, as recommended by their public health and government officials. 

 

On March 16, 2020 , the ADA issued a recommendation for dentists to postpone elective procedures.

https://success.ada.org/en/practice-management/patients/infectious-diseases-2019-novel-coronavirus

While it seems unlikely that many of our members will be treating a symptomatic patient with active disease, guidelines regarding pathogen transmission and the anesthesia work environment have been published by the American Society of Anesthesiologists (ASA) Anesthesia Patient Safety Foundation (APSF).

https://www.apsf.org/news-updates/perioperative-considerations-for-the-2... coronavirus-covid-19/

The information on the COVID-19 pandemic is evolving and recommendations for in-office dental procedures may change, which will require additional consideration for all dentist anesthesiologists. 

Wishing safety and health to all our members, their families and their patients.

 

American Society of Dentist Anesthesiologists

Board of Directors