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Development of a Low-Resource Operating Room and a Wide-Awake Orthopedic Surgery Program During the COVID-19 Pandemic.
Turcotte, Justin J; Gelfand, Jeffrey M; Jones, Christopher M; Jackson, Rubie S.
  • Turcotte JJ; Department of Orthopedics, Anne Arundel Medical Center, Annapolis, MD, USA.
  • Gelfand JM; Department of Orthopedics, Anne Arundel Medical Center, Annapolis, MD, USA.
  • Jones CM; Department of Orthopedics, Anne Arundel Medical Center, Annapolis, MD, USA.
  • Jackson RS; Department of Surgery, Fortney Breast Center, Anne Arundel Medical Center, Annapolis, MD, USA.
Surg Innov ; 28(2): 183-188, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1156051
ABSTRACT
Introduction. The COVID-19 pandemic resulted in significant medication, supply and equipment, and provider shortages, limiting the resources available for provision of surgical care. In response to mandates restricting surgery to high-acuity procedures during this period, our institution developed a multidisciplinary Low-Resource Operating Room (LROR) Taskforce in April 2020. This study describes our institutional experience developing an LROR to maintain access to urgent surgical procedures during the peak of the COVID-19 pandemic. Methods. A delineation of available resources and resource replacement strategies was conducted, and a final institution-wide plan for operationalizing the LROR was formed. Specialty-specific subgroups then convened to determine best practices and opportunities for LROR utilization. Orthopedic surgery performed in the LROR using wide-awake local anesthesia no tourniquet (WALANT) is presented as a use case. Results. Overall, 19 limited resources were identified, spanning across the domains of physical space, drugs, devices and equipment, and personnel. Based on the assessment, the decision to proceed with creation of an LROR was made. Sixteen urgent orthopedic surgeries were successfully performed using WALANT without conversion to general anesthesia. Conclusion. In response to the COVID-19 pandemic, a LROR was successfully designed and operationalized. The process for development of a LROR and recommended strategies for operating in a resource-constrained environment may serve as a model for other institutions and facilitate rapid implementation of this care model should the need arise in future pandemic or disaster situations.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Operating Rooms / Orthopedics / Orthopedic Procedures / COVID-19 / Anesthesia, Local Limits: Humans Language: English Journal: Surg Innov Year: 2021 Document Type: Article Affiliation country: 15533506211003530

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Operating Rooms / Orthopedics / Orthopedic Procedures / COVID-19 / Anesthesia, Local Limits: Humans Language: English Journal: Surg Innov Year: 2021 Document Type: Article Affiliation country: 15533506211003530