TABLE 1.
Adaptative measures in endoscopic units
| Adaptative measure | Comment |
|---|---|
| Pre‐procedure | |
| Change in patient indications | Emergent and urgent indications in first wave; return to pre‐COVID‐19 activity, with re‐triage and prioritization of patients |
| Triage of symptoms/signs of infection, high‐risk contacts, and travel to high‐risk areas | Universal; 2–3 days before endoscopy and at admission |
| Limitation of family members at the hospital | Possible difficult communication. Phone contact policy with relatives is useful |
| Pre‐procedural swab testing | Significant healthcare burden and costs; not universally adopted, but may be useful depending on the local phase of the pandemic and resources |
| Linear flow of patients throughout units | Strict social distancing rules; minimization of time spent in departments |
| Procedure | |
| Limitation of staff members in the endoscopy suit | Impact in training |
| Protective personal equipment use; appropriate donning and doffing | According to local policy/guidelines |
| Barrier protection | Not universally adopted but in development (transparent aerosol boxes, plastic shields); questionable benefit if other protective measures are strictly followed |
| Negative pressure rooms | For procedures in COVID‐19 positive patients/high‐suspicion patients pending results |
| Post‐procedure | |
| Enhanced cleaning procedures | According to local policy/guidelines |
| Routine high‐level disinfection | Minimal/null risk of transmission through endoscopes after high‐level disinfection |
| Procedural room downtime | Depending on patient COVID‐19 status, room volume, changes per hour |
| Post‐procedure patient tracking/contact | Tracking of contacts |