Title: ‘Essential Surgery and Anaesthesia care in Patients Suspected of Ebola Virus Disease (EVD)’. Co-Chairs: Professor Philippe Scherpereel (Lille, France) and Professor Davy Cheng (London, Canada).
- Impact of EVD on surgery and anaesthesia care (Dr. Meena Cherian, Geneva Switzerland)
- Lessons learned from EVD management by perioperative healthcare workers (Dr. Jenny Stedmon, Brisbane, Australia)
- Guidelines on surgery and anaesthesia care in EVD (Prof. Davy Cheng, London, Canada)
Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name. The current outbreak in West Africa (the index case of a two-year-old child in the remote Guinean village in December 2013), with the first cases reported in March 2014, was declared by WHO in August 2014 as an EVD Epidemic of ‘Public Health Emergency of International Concern’. The EVD has since infected over 28,637 cases worldwide with 11,315 deaths by 27 December 2015.
While surgery is not a specific part of the treatment plan for EVD patients, the risk of routine and emergency surgery being performed unknowingly in patients presenting for surgery is high. Tragic deaths of healthcare workers continue to be reported, due to EVD transmission after occupational exposure. On the other hand, in some cases, patients unnecessarily die without emergency surgeries being performed because of the confounding symptoms of fever, vomiting, diarrhoea, abdominal pain, and bleeding manifestations common to both EVD and surgical conditions.
This WFSA Symposium on EVD will start with Dr. Meena Cherian, who is the Past Lead of the Emergency and Essential Surgery Care (EESC) Program at the World Health Organization (WHO). She will present a survey of all the West Africa infected member states on healthcare workers’ exposure and infection mortality rate, as well as the resource availability and the challenges of potential EVD-infected patients not receiving any medical care.
The second speaker, Dr. Jenny Stedmon, an anaesthesiologist and a Red Cross veteran who has worked in EVD out-break field hospitals, will provide the clinical context and practical aspect of the perioperative care as a healthcare provider. In particular, she will recount her personal experience of her encounter with the infection rate, mortality rate, and patient access to proper care versus risk of healthcare workers’ exposure to EVD.
The final speaker will be Prof. Davy Cheng, who is the Chair/Chief of the Department of Anaesthesia & Perioperative Medicine and the Medical Director of the Medical Evidence, Decision Integrity, Clinical Impact (MEDICI) centre at Western University. He and his team (Dr. Janet Martin) have been consulted by WHO to lead development of a guideline for surgery and anaesthesia care in patients with suspected EVD. They will present the current evidence and recommended guidelines on these clinical questions (Assessment and screening, Diagnostic Testing, Isolation and Triage, Surgical Decision-making, and Perioperative Surgical and Anaesthesia management). A practical algorithm on evidence-informed decision making for the management of patients with surgical conditions in the context of EVD will be presented.