Implementation of Preoperative Screening Protocols in Otolaryngology During the COVID-19 Pandemic

Otolaryngol Head Neck Surg. 2020 Aug;163(2):265-270. doi: 10.1177/0194599820931041. Epub 2020 May 26.


Objective: To highlight emerging preoperative screening protocols and document workflow challenges and successes during the early weeks of the COVID-19 pandemic.

Methods: This retrospective cohort study was conducted at a large urban tertiary care medical center. Thirty-two patients undergoing operative procedures during the COVID-19 pandemic were placed into 2 preoperative screening protocols. Early in the pandemic a "high-risk case protocol" was utilized to maximize available resources. As information and technology evolved, a "universal point-of-care protocol" was implemented.

Results: Of 32 patients, 25 were screened prior to surgery. Three (12%) tested positive for COVID-19. In all 3 cases, the procedure was delayed, and patients were admitted for treatment or discharged under home quarantine. During this period, 86% of operative procedures were indicated for treatment of oncologic disease. There was no significant delay in arrival to the operating room for patients undergoing point-of-care screening immediately prior to their procedure (P = .92).

Discussion: Currently, few studies address preoperative screening for COVID-19. A substantial proportion of individuals in this cohort tested positive, and both protocols identified positive cases. The major strengths of the point-of-care protocol are ease of administration, avoiding subsequent exposures after testing, and relieving strain on "COVID-19 clinics" or other community testing facilities.

Implications for practice: Preoperative screening is a critical aspect of safe surgical practice in the midst of the widespread pandemic. Rapid implementation of universal point-of-care screening is possible without major workflow adjustments or operative delays.

Keywords: COVID-19; PS/QI; coronavirus; operating room; otolaryngology; preoperative; protocol; screening; surgery.

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • COVID-19 Testing
  • Chicago
  • Clinical Laboratory Techniques / methods*
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / epidemiology
  • Humans
  • Mass Screening
  • Otolaryngology / methods
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / epidemiology
  • Point-of-Care Testing* / organization & administration
  • Preoperative Care*
  • Retrospective Studies
  • SARS-CoV-2
  • Tertiary Care Centers