Management of Orthopaedic Accidental Emergencies Amidst COVID-19 Pandemic: Our Experience in Preparing to Live with Coro
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ORIGINAL ARTICLE
Management of Orthopaedic Accidental Emergencies Amidst COVID‑19 Pandemic: Our Experience in Preparing to Live with Corona Vineet Dabas1 · Nishant Bhatia1 · Akash Goel1 · Vedpal Yadav1 · Vineet Bajaj1 · Vinod Kumar1 Received: 4 August 2020 / Accepted: 2 September 2020 © Indian Orthopaedics Association 2020
Abstract Introduction With increasing prevalence of coronavirus cases (including among health care providers), the current advice for orthopaedic surgeons is to favor non-operative management of most injuries and reduce face-to-face follow-up. We present our experience in managing the patients at Government-run non-COVID-19 trauma center in Delhi in an algorithmic form. Our standard operating protocols were mainly based on recommendations of Indian Orthopaedic Association and targeted to provide healthcare at a minimum risk to the treating team as well as other patients admitted to the hospital. Methodology We describe the inflow, in-hospital management and outflow of patients at our facility during the lockdown period and in the following unlock period (from 23 March to 8 July 2020). Those patients who had absolute indications for surgery were offered surgery, while conservative treatment was more favored in those with relative indications. We also highlight the changes incorporated in OT settings as well as in rehabilitative and follow-up period. Results Following the described protocol helped us maintain a balance between the safety of patients and our front line workers which was evident by very low COVID-19-positive rate in admitted patients (4.22%) and health care providers (16.67%) in the above-mentioned time period. Conclusions We need to be prepared to cohabitate with this deadly Novel Coronavirus and adapt our surgical practices according to the need of the hour by minimizing surgical indications and strengthening the training in conservative principles. Keywords Coronavirus · Orthopaedic emergencies · Pandemic · Trauma · Healthcare provider · Protection
Introduction
* Vineet Dabas [email protected] Nishant Bhatia [email protected] Akash Goel [email protected] Vedpal Yadav [email protected] Vineet Bajaj [email protected] Vinod Kumar [email protected] 1
Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
The first reports of coronavirus (COVID-19) outbreak came from Wuhan city of China in the month of December 2019 [1]. It was declared as a global pandemic by World Health Organization (WHO) on 11 March 2020 [2]. As of 25 July 2020, 15,296,926 cases and 628,903 deaths have been reported worldwide [3]. In India, the first case of COVID19 was reported on 30 January 2020, and the number has reached 1,287,945 as on 25 July 2020, with 30,601 deaths [4]. The most effective strategies against COVID-19 include preventing exposure and staying indoors. Keeping this in mind, the Government of India (GOI) declared a nationwide lockdown on 23 March 2020 for a period of 3 weeks which was extended
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