TABLE 1.

Additional measures that should be undertaken when performing intra‐articular injections in PWH in the COVID‐19 era

Preprocedure

Known COVID‐19‐positive patients or those who present a clear risk (with symptoms or epidemiological contacts) should be postponed for the procedure whenever it is not essential

Make a complete evaluation before indicating any new procedure. Whenever possible, face‐to‐face contact should be minimized by previously reviewing the electronic history and having a telematic consultation

The patient should sign an informed consent form adapted to the current epidemiological scenario

Consider replacing professionals who have a higher risk of complications from COVID‐19

All personnel must be specifically trained to put on and dispose of PPE

There should be separate pathways to keep suspected/infected patients separated from non‐infected patients

The patient should be called in late in the day and ideally in a room prepared for the rest of the patients

During procedure

Minimize the time of exposure and limit the number of people in the room to the minimum personnel needed

Healthcare personnel must use complete PPE

Patients should wear a surgical mask, gloves and tights during their care

All potential medication should be prepared and placed avoiding the manipulation of medication carts

The infusion of coagulation factor prior to the technique will be done in the same room as the procedure

The use of corticosteroids should be discouraged if possible

All the material potentially necessary for the procedure should be for single use and be available inside the room

It is necessary to disinfect the puncture area with a hydroalcoholic chlorhexidine solution

If anaesthesia is required, local techniques should be used whenever possible

If technical equipment is used, such as ultrasound, it must be adequately protected

Postprocedure

All personnel must be specifically trained to take off the PPE

The subsequent monitoring during recovery will be done in the same room as the procedure

The waste generated is considered class III and must be disposed of as special biosanitary waste

Cleaning and disinfection with viricides should be carried out between patients

All centres must have adequate cleaning, disinfection and waste management protocols

Abbreviations: PEE, personal protective equipment; PWH, people with haemophilia.