ABSTRACT
PURPOSE: The COVID-19 pandemic has impacted healthcare systems globally, little is known about the trauma patterns during a national lockdown. The aim of this study is to delineate the trauma patterns and outcomes at Aintree University Teaching Hospital level 1 Major Trauma Centre (MTC) during the COVID-19 lockdown imposed by the U.K. government. METHODS: A retrospective cohort study data from the Merseyside and Cheshire Trauma Audit and Research Network database were analysed. The 7-week 'lockdown period' was compared to a 7-week period prior to the lockdown and also to an equivalent 7-week period corresponding to the previous year. RESULTS: A total of 488 patients were included in the study. Overall, there was 37.6% and 30.0% reduction in the number of traumatic injuries during lockdown. Road traffic collisions (RTC) reduced by 42.6% and 46.6%. RTC involving a car significantly reduced during lockdown, conversely, bike-related RTC significantly increased. No significant changes were noted in deliberate self-harm, trauma severity and crude mortality during lockdown. There was 1 mortality from COVID-19 infection in the lockdown cohort. CONCLUSION: Trauma continues during lockdown, our MTC has continued to provide a full service during lockdown. However, trauma patterns have changed and departments should adapt to balance these alongside the COVID-19 pandemic. As the U.K. starts its cautious transition out of lockdown, trauma services are required to be flexible during changes in national social restrictions and changing trauma patterns. COVID-19 and lockdown state were found to have no significant impact on survival outcomes for trauma.
Subject(s)
COVID-19 , Emergency Service, Hospital/statistics & numerical data , Infection Control , Surgical Procedures, Operative/statistics & numerical data , Wounds and Injuries , Accidents, Traffic/statistics & numerical data , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Clinical Audit/methods , Clinical Audit/statistics & numerical data , Female , Humans , Infection Control/methods , Infection Control/organization & administration , Male , Retrospective Studies , SARS-CoV-2 , Self-Injurious Behavior/epidemiology , Trauma Centers/statistics & numerical data , Trauma Severity Indices , United Kingdom/epidemiology , Wounds and Injuries/classification , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology , Wounds and Injuries/therapyABSTRACT
The erector spinae plane block is an interfascial plane block whereby local anesthetic is injected within the plane deep to the erector spinae muscle and superficial to the transverse process. To date, it has been used to provide analgesia in thoracic, abdominal, and lumbar regions. We present the first reported case of bilateral erector spinae plane block being used to provide surgical anesthesia in the cervical region.