Anaesthetic challenges in a child with perforated appendicitis and COVID-19 Co-Infection: A case report

• Main Authors: Annie Maxwell, Teah, Kai Ming, Soe, May Zaw, Yeap, Boon Tat
• Format: Article
• Language: English; English
• Published: Elsevier Ltd 2021
• Subjects: RA440-440.87 Study and teaching. Research; RA648.5-767 Epidemics. Epidemiology. Quarantine. Disinfection
• Online Access: https://eprints.ums.edu.my/id/eprint/31349/1/Anaesthetic%20challenges%20in%20a%20child%20with%20perforated%20appendicitis%20and%20COVID-19%20Co-Infection.pdf; https://eprints.ums.edu.my/id/eprint/31349/2/Anaesthetic%20challenges%20in%20a%20child%20with%20perforated%20appendicitis%20and%20COVID-19%20Co-Infection1.pdf; https://eprints.ums.edu.my/id/eprint/31349/; https://reader.elsevier.com/reader/sd/pii/S2049080121008815?token=383E9DE234274C4E8AA9412644F893942F795897E66C328B34A974D18393E935F9608056CC20FAB40C94A626509A656F&originRegion=eu-west-1&originCreation=20211129130957; https://doi.org/10.1016/j.amsu.2021.102931
• Institution: Universiti Malaysia Sabah

Background: The deadly coronavirus disease 2019 (COVID-19) wreaked havoc globally in early 2020 and caused lives to a standstill. Healthcare workers (HCW) handling patients infected with COVID-19 wore protective equipment to defend themselves from cross infection and curbing further spread. Nevertheless, these do hamper their dexterity, especially during surgical procedures. Case presentation: A child presented to our centre needing an emergency open appendicectomy during the coronavirus disease 2019 (COVID-19) pandemic in June 2021. Prior to the surgery, her initial test for COVID-19 was negative but subsequently became positive on the second test. Fortunately, all HCW during the care for the patient, donned full personal protective equipment (PPE), and avoided cross-infection. Discussion: HCW handling patients with COVID-19 should wear adequate PPE to. However, these pose detrimental effects to their dexterity during routine care of such patients. Good teamwork and communication among HCW and parents are important during the safe management of a young child with COVID-19. Conclusion: HCW should have low index of suspicion of COVID-19 in children with upper respiratory tract infection. Prompt and pro-active measures should be rapidly taken to prevent exposure and co-infection. Wearing multi layers of PPE do negatively affect the mood and agility of HCW handling young children with COVID-19. Thus, they should practice good team work, receive regular simulation and scenario-based training to be better prepared for pressurised situations.