Guidelines for the orthopedic surgeon in the era of COVID-19

Abstract

Amid the current pandemic of coronavirus disease 2019 (COVID-19), orthopaedic surgery was one of the fewer specialties that remained active managing emergent and urgent orthopaedic and trauma cases. On the other hand, with the continued spread of this pandemic and its associated socioeconomic confinement and unpredictability of the pandemic curve; many health care facilities were forced into halting all elective and non-urgent activities including orthopaedic specialties. This in part was to help in reallocation of required resources and focusing on the proper management of COVID-19 patients, and to prevent the transmission of infection among health care workers and patients. In this article we analyzed developments and recommendations of international reports about the current outbreak and its impact on the practice of orthopaedic surgery. Our aim was to provide comprehensive and easy guidelines for the management of urgent and emergent cases in hot zones and for the process of returning to usual orthopaedic work flow in a balanced strategy to assure safe practice and providing quality care without the risk of exhausting institutional resources or the risk of COVID- 19 transmission among health care workers or patients

Patient Throughput Initiatives in Ambulatory Care Organizations during the COVID-19 Pandemic: A Systematic Review

“…An ongoing initiative to maintain a high level of quality ambulatory/outpatient care continues to challenge the U.S. healthcare system as the COVID-19 pandemic continues. Evidence from this review suggests that enhanced safety and patient distancing protocols [20,27,41], in conjunction with appropriate provider training centered around such public health initiatives [19,23,31]. enhance outpatient providers' ability to increase patient throughput.…”

“…One major reason for protocol development was to ensure that surgical resources are allocated to the correct patient population. Seen in patients in need of orthopedic surgery during the pandemic, protocols were developed to make sure that only necessary emergency surgery were done while others were managed medically until a strain on hospital resources was reduced [27,32]. Another type of protocol that was developed during this time were safety protocols to ensure patients and staff remained safe from the COVID 19 virus.…”

“…Another type of protocol that was developed during this time were safety protocols to ensure patients and staff remained safe from the COVID 19 virus. With the implementation of safety protocols for in-person visits, it was found that patients were more likely to stay on treatment regimens with the extra layer of protection these protocols provided [14,27,34,41]. Lastly a protocol theme was identified surrounding how to evaluate staffing levels to ensure that areas in high need of staff were assisted by areas with a lighter workload.…”

“…Lack of knowledge of protocols and workflow as to how to proceed with orthopedic surgical cases, due to the unprecedented burden brought by the current pandemic, halted surgical cases in healthcare facilities and outpatient clinics. More comprehensive guidelines for the orthopedic surgeon in the era of COVID-19 were needed to maintain a safe and effective practice to resume surgical cases [27].…”