Infection control measures for operative procedures in severe acute respiratory syndrome-related patients.
BACKGROUND
Singapore reported its first case of Severe Acute Respiratory Syndrome (SARS) in early March 2003 and was placed on the World Health Organization's list of SARS-affected countries on March 15, 2003. During the outbreak, Tan Tock Seng Hospital was designated as the national SARS hospital in Singapore to manage all known SARS patients. Stringent infection control measures were introduced to protect healthcare workers and control intrahospital transmission of SARS. Work-flow processes for surgery were extensively modified.


METHODS
The authors describe the development of infection control measures, the conduct of surgical procedures, and the management of high-risk procedures during the SARS outbreak.


RESULTS
Forty-one operative procedures, including 15 high-risk procedures (surgical tracheostomy), were performed on SARS-related patients. One hundred twenty-four healthcare workers had direct contact with SARS patients during these procedures. There was no transmission of SARS within the operating room complex.


CONCLUSIONS
Staff personal protection, patient risk categorization, and reorganization of operating room workflow processes formed the key elements for the containment of SARS transmission. Lessons learned during this outbreak will help in the planning and execution of infection control measures, should another outbreak occur.
Chee
Victor Wei Ter
VW
Department of Anaesthesiology, Tan Tock Sang Hospital, Singapore. victor_chee@ttsh.com.sg
Khoo
Mark Li-Chung
ML
Lee
Sow Fong
SF
Lai
Yeow Choy
YC
Chin
Ngek Mien
NM
D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000706:statistics & numerical data; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data; D008505:Medical Staff, Hospital / Q000592:standards / Q000706:statistics & numerical data; D009873:Operating Rooms / Q000592:standards / Q000706:statistics & numerical data; D012308:Risk Management / Q000379:methods; D045169:Severe Acute Respiratory Syndrome / Q000517:prevention & control* / Q000635:transmission*