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Orthopaedic assessment unit: a service model for the delivery of orthopaedic trauma care in a major trauma centre during the global pandemic (COVID-19).
Lim, J W; Rehman, H; Gaba, S; Sargeant, H; Stevenson, I M; Boddie, D E.
  • Lim JW; Aberdeen Royal Infirmary, Aberdeen, UK.
  • Rehman H; Aberdeen Royal Infirmary, Aberdeen, UK.
  • Gaba S; Aberdeen Royal Infirmary, Aberdeen, UK.
  • Sargeant H; Aberdeen Royal Infirmary, Aberdeen, UK.
  • Stevenson IM; Aberdeen Royal Infirmary, Aberdeen, UK.
  • Boddie DE; Aberdeen Royal Infirmary, Aberdeen, UK.
Ann R Coll Surg Engl ; 103(3): 167-172, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1154068
ABSTRACT

INTRODUCTION:

We describe a new service model, the Orthopaedic Assessment Unit (OAU), designed to provide care for trauma patients during the COVID-19 pandemic. Patients without COVID-19 symptoms and isolated musculoskeletal injuries were redirected to the OAU.

METHODS:

We prospectively reviewed patients throughput during the peak of the global pandemic (7 May 2020 to 7 June 2020) and compared with our historic service provision (7 May 2019 to 7 June 2019). The Mann-Whitney and Fisher Exact tests were used to test the statistical significance of data.

RESULTS:

A total of 1,147 patients were seen, with peak attendances between 11am and 2pm; 96% of all referrals were seen within 4h. The majority of patients were seen by orthopaedic registrars (52%) and nurse practitioners (44%). The majority of patients suffered from sprains and strains (39%), followed by fractures (22%) and wounds (20%); 73% of patients were discharged on the same day, 15% given follow up, 8% underwent surgery and 3% were admitted but did not undergo surgery. Our volume of trauma admissions and theatre cases decreased by 22% and 17%, respectively (p=0.058; 0.139). There was a significant reduction of virtual fracture clinic referrals after reconfiguration of services (p<0.001).

CONCLUSIONS:

Rapid implementation of a specialist OAU during a pandemic can provide early definitive trauma care while exceeding national waiting time standards. The fall in trauma attendances was lower than anticipated. The retention of orthopaedic staff in the department to staff the unit and maintain a high standard of care is imperative.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Orthopedics / Sprains and Strains / Delivery of Health Care / Fractures, Bone Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Ann R Coll Surg Engl Year: 2021 Document Type: Article Affiliation country: Rcsann.2020.7069

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Orthopedics / Sprains and Strains / Delivery of Health Care / Fractures, Bone Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Ann R Coll Surg Engl Year: 2021 Document Type: Article Affiliation country: Rcsann.2020.7069