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骨科手术选择和冠状病毒(COVID-19)大流行期间的住院模式。

Orthopaedic Surgical Selection and Inpatient Paradigms During the Coronavirus (COVID-19) Pandemic.

机构信息

From the Department of Orthopaedic Surgery, Louisiana State University Health, Shreveport, LA (Dr. Massey, Dr. McClary, Dr. Zhang, and Dr. Barton), and the Department of Orthopaedic Surgery, Tulane Medical Center, New Orleans, LA (Dr. Savoie).

出版信息

J Am Acad Orthop Surg. 2020 Jun 1;28(11):436-450. doi: 10.5435/JAAOS-D-20-00360.

Abstract

The novel coronavirus pandemic, also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has placed an immense strain on healthcare systems across the entire world. Consequently, multiple federal and state governments have placed restrictions on hospitals such as limiting "elective surgery" and recommending social or physical distancing. We review the literature on several areas that have been affected including surgical selection, inpatient care, and physician well-being. These areas affecting inpatient paradigms include surgical priority, physical or social distancing, file sharing for online clinical communications, and physician wellness. During this crisis, it is important that orthopaedic departments place an emphasis on personnel safety and slowing the spread of the virus so that the department can still maintain vital functions. Physical distancing and emerging technologies such as inpatient telemedicine and online file sharing applications can enable orthopaedic programs to still function while attempting to protect medical staff and patients from the novel coronavirus spread. This literature review sought to provide evidence-based guidance to orthopaedic departments during an unprecedented time. Orthopaedic surgeons should follow the Centers for Disease Control and Prevention guidelines, wear personal protective equipment (PPE) when appropriate, have teams created using physical distancing, understand the department's policy on elective surgery, and engage in routines which enhance physician wellness.

摘要

新型冠状病毒大流行,又称严重急性呼吸系统综合症冠状病毒 2 型(SARS-CoV-2),已对全球各地的医疗体系造成巨大压力。因此,多个联邦和州政府对医院实施了限制,例如限制“择期手术”并建议保持社交或身体距离。我们回顾了受影响的几个领域的文献,包括手术选择、住院治疗和医生健康。这些影响住院模式的领域包括手术优先级、身体或社会距离、用于在线临床通信的文件共享以及医生健康。在这场危机中,骨科部门重视人员安全和减缓病毒传播非常重要,以便部门仍能维持重要功能。身体距离和新兴技术,如住院远程医疗和在线文件共享应用程序,可以使骨科项目在努力保护医务人员和患者免受新型冠状病毒传播的同时仍能运作。本文献综述旨在为前所未有的时期的骨科部门提供循证指导。骨科医生应遵循疾病控制和预防中心的指导方针,在适当情况下穿戴个人防护设备(PPE),使用身体距离创建团队,了解科室关于择期手术的政策,并进行增强医生健康的常规活动。

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