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

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.

Publication types

  • Review

MeSH terms

  • COVID-19
  • Communicable Disease Control / organization & administration*
  • Coronavirus Infections* / epidemiology
  • Elective Surgical Procedures / methods
  • Elective Surgical Procedures / statistics & numerical data
  • Female
  • Humans
  • Inpatients / statistics & numerical data
  • Male
  • Occupational Health
  • Orthopedic Procedures / statistics & numerical data
  • Orthopedic Procedures / trends
  • Pandemics / prevention & control*
  • Patient Isolation / methods
  • Patient Safety
  • Patient Selection
  • Personal Protective Equipment / statistics & numerical data*
  • Pneumonia, Viral*
  • Program Development
  • Program Evaluation
  • Safety Management / organization & administration*
  • United States