Management of Traumatology Patients During the Coronavirus (COVID-19) Pandemic: Experience in a Hub Trauma Hospital in N
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ORIGINAL ARTICLE
Management of Traumatology Patients During the Coronavirus (COVID‑19) Pandemic: Experience in a Hub Trauma Hospital in Northern Italy Fabio D’Angelo1 · Luca Monestier2 · Giovanni De Falco2 · Michael Mazzacane2 · Placido Stissi3 Received: 25 July 2020 / Accepted: 29 September 2020 © The Author(s) 2020
Abstract Background As a result of the uncontrolled spread of the COVID-19 virus infection, a health reorganization according to the “hub and spoke” model was necessary. The purpose of the article was to document the adopted corporate protocol and describe the management of the traumatized patient in a Hub center. Methods Our hospital has been identified as one of the three regional Hubs for polytrauma and major traumas, requiring suitable pathways to receive confirmed or suspected COVID-19-positive patients, from the emergency room entrance to the operating room, and finally to the inpatient ward or ICU. From February 23th to April 30th 2020 we analyzed the total number of trauma patients hospitalized and the number of femoral neck fractures surgically treated within 48 h; the data were then compared with the corresponding period of the previous year. Results There has been a reduction in the overall number of traumas as a result of government restraint measures. Total occupancy time in the operating theater has increased, but not drastically considering dressing procedures and anesthesia (carried out inside the operating room). The number of patients with femoral neck fractures surgically treated within 48 h (none of the COVID-19-positive patients) decreased from 83.33 to 58.70%, but only slightly lower than the Italian preCOVID average of 64.70%. Conclusions The correct management of the hospital and the meticulous organization of the traumatized patient have made it possible to contain the potential negative effects on the medical care quality during this unexpected and severe health emergency. Keywords COVID-19 · Trauma · Proximal femoral fracture · Management · Pandemic Abbreviations COVID-19 COronaVIrus Disease-19 ICU Intensive Care Unit
* Fabio D’Angelo [email protected] 1
Division of Orthopaedics and Traumatology, Department of Biotechnologies and Life Sciences (DBSV), ASST Dei Sette Laghi, University of Insubria, Varese, Italy
2
Division of Orthopaedics and Traumatology, ASST Sette Laghi, Varese, Italy
3
Residency Program in Orthopedics and Trauma, Division of Orthopaedics and Traumatology, Department of Biotechnologies and Life Sciences (DBSV), ASST dei Sette Laghi, University of Insubria, Varese, Italy
Background COVID-19 is the infectious disease caused by the SARSCoV-2 coronavirus. As the infection has spread to most of the world, the World Health Organization declared this novel outbreak a pandemic on March 11th, 2020. On April 30th, Italy has been one of the most affected countries in the whole world with 205,463 total cases and 27,967 deaths. Most cases occurred in Lombardy, a northern district with about 10 million inhabitants: 71,256 cases
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