Department of Traumatology and Orthopedic Surgery, University Hospital of Vall d'Hebron. 119-129, 08035, Barcelona, Spain; Universitat Autónoma de Barcelona, Barcelona, Spain.
Department of Traumatology and Orthopedic Surgery, University Hospital of Vall d'Hebron. 119-129, 08035, Barcelona, Spain; Universitat Autónoma de Barcelona, Barcelona, Spain.
Injury. 2020 Dec;51(12):2827-2833. doi: 10.1016/j.injury.2020.09.055. Epub 2020 Sep 25.
The severe disruptions caused by the SARS-CoV-2 coronavirus have necessitated a redistribution of resources to meet hospitals' current service needs during this pandemic. The aim is to share our experiences and outcomes during the first month of the Covid-19 pandemic, based on the strategies recommended and strategies we have implemented.
Our experience comes from our work at a referral hospital within the Spanish National Health System. Changes to clinical practice have largely been guided by the current evidence and four main principles: (1) patient and health-care worker protection, (2) uninterrupted necessary care, (3) conservation of health-care resources, (4) uninterrupted formation for residents. Based on these principles, changes in the service organization, elective clinical visits, emergency visits, surgical procedures, and inpatient and outpatient care were made.
Using the guidance of experts, we were able to help the hospital address the demands of the Covid-19 outbreak. We reduced to a third of our orthopaedics and trauma hospital beds, provided coverage for general emergency services, and five ICUs, all continuing to provide care for our patients, in the form of 102 trauma surgeries, 6413 phone interviews and 520 emergency clinic visits. Also in the third week, we were able to restart morning meetings via telematics, and teaching sessions for our residents. On the other hand, eight of the healthcare personnel on our service (10.8%) became infected with Covid-19.
As priorities and resources increasingly shift towards the COVID-19 pandemic, it is possible to maintain the high standard and quality of care necessary for trauma and orthopaedics patients while the pandemic persists. We must be prepared to organize our healthcare workers in such a way that the needs of both inpatients and outpatients are met. It is still possible to operate on those patients who need it. Unfortunately, some healthcare workers will become infected. It is essential that we protect those most susceptible to severer consequences of Covid-19. Also crucial are optimized protective measures.
SARS-CoV-2 冠状病毒造成的严重干扰使得资源重新分配成为必要，以满足医院在当前大流行期间的服务需求。我们旨在根据推荐的策略和实施的策略，分享我们在 Covid-19 大流行第一个月的经验和结果。
我们的经验来自于我们在西班牙国家卫生系统的一家转诊医院的工作。临床实践的改变主要是基于当前的证据和四个主要原则：（1）保护患者和医护人员，（2）不间断的必要护理，（3）保护医疗资源，（4）为住院医师提供不间断的培训。基于这些原则，对服务组织、选择性临床访问、急诊访问、手术程序以及住院和门诊护理进行了调整。
在专家的指导下，我们帮助医院应对了 Covid-19 疫情的需求。我们将骨科和创伤医院的床位减少到三分之一，为普通急诊服务和五家 ICU 提供了覆盖，所有这些都继续为我们的患者提供护理，共进行了 102 例创伤手术、6413 次电话咨询和 520 次急诊就诊。同样在第三周，我们通过远程医疗恢复了晨间会议和住院医师的教学课程。另一方面，我们服务部门的八名医护人员（10.8%）感染了 Covid-19。
随着优先事项和资源越来越向 COVID-19 大流行转移，在大流行持续期间，有可能维持创伤和骨科患者所需的高标准和高质量的护理。我们必须准备好组织我们的医护人员，以满足住院和门诊患者的需求。仍然有可能为那些需要手术的患者进行手术。不幸的是，一些医护人员会感染。保护那些最容易受到 Covid-19 更严重后果影响的人至关重要。同样关键的是优化防护措施。
