Following laparoscopic appendicectomy, should children routinely receive a patient/nurse controlled analgesia device or not?
Update 19th September 2020
The COVID-19 pandemic has resulted in the cessation of all but the most urgent elective children's surgery during the period of peak prevalence of infection in the general population. Guidance was updated on 17th September on evidence based practice that will enable the recovery of children's elective surgery. This has been the result of a huge collective effort by ourselves and numerous other contributors including the RCoA, RCPCH, BAPS, RCS England and the Association of Perioperative Practice, supported by Professor Simon Kenny, the National Clinical Director for Children.
There are elements of this which will help all off us optimise the time window we have whilst prevalence is low and before winter pressures start adding to our problems. The guidance is responsive to local prevalence conditions which allows change in response to changes in local prevalence of COVID.
The guidance has not been approved by NHSE yet, and this is being sought which will provide extra assurance. In view of this, there will need to be local agreement with each Trust’s appropriate teams as to implementation of all or specific elements of this guidance.
Some of the nuances of the rapid guidelines development means that certain elements PPE requirements could not be covered so again local considerations of the evidence in the guidelines should be used to help any changes to existing policy.