{"id":30566,"date":"2020-04-05T10:00:44","date_gmt":"2020-04-05T16:00:44","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=30566"},"modified":"2023-09-28T16:03:10","modified_gmt":"2023-09-28T22:03:10","slug":"orthopedic-trauma-services-ready-during-the-coronavirus-pandemic","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/orthopedic-trauma-services-ready-during-the-coronavirus-pandemic\/","title":{"rendered":"What if you break a hip (or leg, or whatever) during a pandemic?"},"content":{"rendered":"
<\/div>
\"orthopedic
Dr. Jason Stoneback with added virus protection in the UCHealth University of Colorado Hospital OR. Photo courtesy of Jason Stoneback.<\/figcaption><\/figure>\n

The new coronavirus is rightly, and almost entirely, devouring news cycles. But even as COVID-19 swamps our attention and stretches the capacity of our health care institutions, those who might in \u201cnormal\u201d times end up at UCHealth hospitals for other reasons are still coming. The SARS-CoV-2 virus hasn\u2019t erased heart attacks, organ failures, cancers, injuries, or other illnesses and chronic conditions that need medical attention. The virus is, rather, an addition to and complicator of the many health problems people have anyway.<\/p>\n

A hypothetical example: a 75-year-old woman with a heart condition falls and breaks her hip. She needs emergency orthopedic surgery. An ambulance arrives, destination UCHealth University of Colorado Hospital<\/a> on the Anschutz Medical Campus<\/a>. The hospital, like every other hospital in the United States, is increasingly occupied by COVID-19 patients. The patient is in a demographic known to face very high risk should she become infected. The hospital can handle it. But how does<\/em> the hospital handle it?<\/p>\n

Dr. Jason Stoneback<\/a>, a UCHealth and University of Colorado School of Medicine orthopedic trauma surgeon, took the lead in figuring that out for Orthopedic Trauma. He considered three primary factors. First, people would still be getting hurt \u2013 and not only locally. UCH would continue to receive badly injured patients and those with infected, non-healing injuries from hospitals across the region. That\u2019s just how it is at a level-one trauma center with an American Burn Association-verified burn center. UCH can treat patients many other hospitals just can\u2019t.<\/p>\n

Second, his team would have to provide care to patients while at the same time doing all they could to protect patients from COVID-19.<\/p>\n

\n

You can schedule an appointment with an orthopedic or spine specialist from the comfort of your home through a <\/strong>Virtual Visit<\/a>.<\/strong><\/p>\n<\/div>\n

Third, Stoneback and colleagues would have to protect themselves from COVID-19. That would mean being careful about the amount of time orthopedic trauma doctors and nurses spent in inpatient units as well as taking measures to ensure that, should a patient arrive with not only a broken hip but also COVID-19, the UCHealth team could treat the hip without exposure to the disease.<\/p>\n

Not business as usual for orthopedic trauma during the coronavirus pandemic<\/strong><\/h2>\n

Recognizing the need to open up beds for a possible wave of COVID-19 patients, University of Colorado School of Medicine Department of Orthopedics Chair Dr. Evalina Burger<\/a> announced on March 15 that surgeries \u2013 knee and hip replacements being prime examples \u2013 would be delayed across UCHealth. (Four days later, Colorado Gov. Jared Polis halted all elective procedures statewide.) Orthopedics\u2019 move would free up beds and minimize the exposure of orthopedics patients to the coronavirus.<\/p>\n

\u201cWe were ahead of the curve on that, but we felt that we had to lead,\u201d Stoneback said.<\/p>\n

While some UCHealth Orthopedic Traumatology surgeries \u2013 certain limb-restoration<\/a> procedures, for example \u2013 may reside at the fringes of \u201celective,\u201d the majority of the service\u2019s work is urgent, and it continues. To do so safely, Stoneback and colleagues instituted several changes to how they approach their work.<\/p>\n

\"x-ray
: Orthopedic injuries don\u2019t stop with a pandemic. Here, an X-ray image of a broken leg after an orthopedic trauma surgery of a bad leg break. There will be follow-up surgeries. Photo courtesy of Jason Stoneback.<\/figcaption><\/figure>\n

The team\u2019s daily morning meeting \u2013 typically a standing-room-only affair involving about 25 doctors, physician assistants and nurse practitioners, nurses, medical students, and others discussing past and upcoming cases \u2013 was cancelled until further notice. To the extent possible, social distancing must apply within a hospital\u2019s walls, too.<\/p>\n

Across Orthopedics, \u201cpatients who absolutely didn\u2019t need to be seen,\u201d as Stoneback put it, were tentatively scheduled for a month later, and the appointments of patients who could be managed remotely were changed from in-clinic visits to telehealth consultations.<\/p>\n

Stoneback and colleagues then divided the Orthopedic Trauma team into three separate teams, each led by a UCH orthopedic trauma surgeon: Stoneback, Dr. Melissa Gorman<\/a>, and Dr. Nicholas Alfonso<\/a>.<\/p>\n

Going lean<\/strong><\/h3>\n

The teams are lean: a surgeon, an advanced-practice provider, and minimal support staff. Each team spends one week onsite at UCH and then works from home the next two weeks, a period that doubles as self-quarantining in case of COVID-19 exposure.<\/p>\n

Similarly, one or two providers do inpatient rounds. They do so without the medical students who are normally in tow. At night, an MD orthopedic surgery resident checks in on patients, sees new patients in the hospital and emergency department with the fellowship-trained surgeons on call.<\/p>\n

Some operations also continue. In addition to standard procedures to minimize infection risk, every provider in the operating room wears an N95 mask. The anesthesiologist wears a special respirator and protective clothing while intubating the patient, and all others leave the OR temporarily to minimize possible exposure during that process, which can aerosolize virus should the patient be infected.<\/p>\n

Taken together, Stoneback says he feels that Orthopedic Trauma patients can feel safe at UCH \u2013 and so can those taking care of them.<\/p>\n

\u201cIt\u2019s about keeping vital services open and how we\u2019re managing it without losing a step,\u201d he says.<\/p>\n

Orthopedic Trauma\u2019s readiness applies more broadly, says Robbie Dumond, UCH\u2019s senior director of Trauma Services.<\/p>\n

\u201cWhat we really want to emphasize to people right now is that all of our emergency services at University of Colorado Hospital are there for patients,\u201d Dumond said. \u201cJust because we\u2019re taking care of COVID-19 patients doesn\u2019t mean we\u2019re any less prepared to take care of a person with trauma, stroke, cardiac event or other emergency.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

The new coronavirus is rightly, and almost entirely, devouring news cycles. But even as COVID-19 swamps our attention and stretches the capacity of our health care institutions, those who might in \u201cnormal\u201d times end up at UCHealth hospitals for other reasons are still coming. The SARS-CoV-2 virus hasn\u2019t erased heart attacks, organ failures, cancers, injuries, […]<\/p>\n","protected":false},"author":23,"featured_media":30569,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6,8],"tags":[4859,4860,392,3372,183,9187,565,257],"class_list":["post-30566","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-living","category-news","tag-coronavirus","tag-covid-19","tag-infection-prevention","tag-orthopedic-trauma-and-fracture-surgery","tag-orthopedics","tag-readysetco","tag-trauma-services","tag-virus-prevention"],"acf":[],"yoast_head":"\nTrauma services ready during the coronavirus pandemic - UCHealth Today<\/title>\n<meta name=\"description\" content=\"How do hospitals handle orthopedic trauma during the coronavirus pandemic? 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