Not all facilities have access to a negative pressure room or have the option to convert rooms from positive to negative pressure settings. This document provides recommendations for managing suspected and confirmed COVID‑19 patients in positive pressure operating theatres.
Where possible, operating theatres should be designated for COVID-19 and non-COVID-19 patients to minimise transmission risk and reduce turnover time between patients.
1 All local processes should be aligned the statewide
Response and Escalation Framework. The ACI
Personal Protective Equipment in the Operating Theatre decision supported tool outlines the minimum standardsd for personal protective equipment to be worn by each health worker in the operating theatre environment.
Where feasible, COVID-19 suspected patients should have rapid testing prior to an emergency procedure. It is vital to ensure all staff caring for COVID positive or suspected patients are fully vaccinated. For respiratory protection, staff must also be fit tested for the appropriate respirator and perform fit checking every time a respirator is donned.
Interim advice for the setup of a positive pressure theatre
Principles of best patient care apply when a positive pressure operating room is the only option available to a healthcare facility while looking after a suspected or confirmed COVID-19 patient, or where a high risk aerosol generating procedure (AGP) is being undertaken.
At all times staff entering a room with a COVID or suspected COVID patient should wear appropriate PPE ( minimum fitted P2/ N95 and eye protection, >+/- protective gown and gloves). There is no requirement to wait any length of time after an AGP if staff are correctly wearing PPE.
* this advice is not available in current guidelines
For the development of the document, a Google search was undertaken in May 2020, July 2021 and repeated in July 2022, using the key search terms positive pressure theatre, negative pressure theatre and COVID-19. No new evidence regarding practical guidance on managing in a positive pressure operating theatre was identified in the July 2022 search. Guidance from state and national bodies has been included in the document. This evidence was supplemented with experiential evidence from subject matters experts to provide practical advice to help solve an infection control issue.
The Anaesthesia Community of Practice Executive developed the document, with input from the broader Anaesthesia Community of Practice. Consultation was undertaken with the Surgery Community of Practice and Infection Prevention and Control Community of Practice. The final document was approved by the Clinical Lead of the Anaesthesia Community of Practice
Anaesthesia Community of Practice.
Dr Nigel Lyons, Deputy Secretary, Health System Strategy and Planning.
District and Network Chief Executives, Directors of Medical Services, Clinical Directors of Anaesthesia, Clinical Directors of Surgery, Surgery Operations Managers, Departments of Anaesthesia and Perioperative Service.