The Arkansas Medical Society (AMS) has received some clarification from the Arkansas Department of Health on its April 27, 2020 Directive on Resuming Elective Procedures. This content below is from AMS’s COVID-19 Update Emails from May 4 and 5, 2020.
In Monday, May 4’s COVID-19 Update, a section was included to clarify that certain urgent procedures were not considered “elective” for purposes of meeting the 48-hour testing rule. The following statement was included, “Physicians should exercise judgment in considering whether or not testing should be done, even though the results might not come back until after the procedure.” Further clarification appears to be in order.
The statement applies only to “non-elective” procedures that do not require testing and if postponed could lead to more severe problems or harm for the patient. Obviously if the patient has any COVID-19 symptoms, exercising judgement would indicate the need to test. Some facilities may soon be routinely testing asymptomatic patients as well. If at all possible, it would be prudent to wait for results. However, in some cases the urgency of the procedure might very well preclude postponing. In that event, if a positive test comes back post-procedure, you would then manage the virus.
AMS is still receiving questions about the testing requirement for elective surgery, so hopefully this guidance will be helpful.
In a nutshell, if a delay in surgery could cause any harm, that surgery would not be considered “elective,” and the current 48-hour testing requirement for elective surgeries would not apply. In other words, if a patient has symptoms that could worsen or lead to other problems, surgery would NOT be considered elective.
An example would be a patient with recurrent ear infections. Surgery to insert tubes would not be considered elective because of the potential harm in delay. Physicians should exercise judgment in considering whether or not testing should be done, even though the results might not come back until after the procedure.
The Arkansas Medical Society has a COVID-19 webpage with a place for you to submit questions. Visit ARKMED.org/covid19 and click on the Got Questions Box.