Management of Traumatology Patients During the Coronavirus (COVID-19) Pandemic: Experience in a Hub Trauma Hospital in Northern Italy

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 pre-COVID 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.

Lessons Learnt from Managing Orthopaedic Trauma During the First Wave of the COVID-19 Pandemic at a UK District General Hospital

“…By contrast, other studies have reported no difference in functional outcomes for patients with hip fractures who experienced a delay in time to operation [20,21]. An increase in waiting time from presentation to operation during the pandemic has been reported by other orthopaedic and trauma departments [14,18]. The delay may reflect hospital policy to wait for a COVID-19 result before operating.…”

“…An increase in waiting time from presentation to operation during the pandemic has been reported by other orthopaedic and trauma departments [ 14 , 18 ]. The delay may reflect hospital policy to wait for a COVID-19 result before operating.…”

“…Alternative explanations could be explained by staff shortages owing to contracting COVID-19. As such, the need for expediting trauma patient care whilst ensuring patient and staff safety is paramount in such unprecedented times [ 14 ].…”

77 Lessons Learnt from Managing Orthopaedic Trauma During the First Wave of the COVID-19 Pandemic at a UK District General Hospital

“…Alternative explanations could be explained by staff shortages owing to contracting COVID-19. As such, the need for expediting trauma patient care while ensuring patient and staff safety is paramount in such unprecedented times [14].…”

Management of Polytrauma in Cases of Suspected Suicidal Falls in Covid-19 Pandemic - A Case Series

“…Patients suffering traumatic injuries involving multiple bony regions with existing or potentially life threatening conditions is referred as polytrauma. [6,7] During this pandemic, there is critical decision making on hospital administration and individual care providers on how to conserve critical resources like N95 maks, personal protective equipment kits, oxygen beds and ICU vacancies. Half of doctors, nurses and other hospital staffs have been diverted to COVID duties.…”