Safety evaluation of providing trauma service during COVID-19 phase one lockdown

Abstract

Aims: To evaluate the safety and transmission of COVID-19 in trauma patients during the coronavirus pandemic at a time of rapid reorganization of hospital health services.

Methods: All patients sustaining trauma requiring surgery treated in our institution during the lockdown period were included. Retrospective data for all admissions were collected, including outcomes, length of stay and complications. Telephone interviews were performed with all patients, families or their carers to assess COVID-19 transmission at minimum of 6 week post-discharge.

Results: 161 patients underwent surgery, 107 females and 54 males with average age of 56 (2-99). There were lower limb related procedures, upper limb related respectively. 13 people died during this period, of these one was directly attributed to COVID-19 related morbidity. 75% responded to telephone interviews and found no cases of symptomatic spread to any patient or household members.

Conclusion: Following reorganization, our experience has shown that trauma services can be safely resumed with little to no significant adverse effect to patient or spread into community, especially as concerns of second wave risk overwhelming the NHS. We advocate that rigorous testing of COVID pre-operatively and with development of local COVID-19 standard operating protocols will also reduce and prevent the spread of COVID-19.

Keywords: COVID −19; Coronavirus; Lockdown; Orthopaedic services; Pandemic; Safety; Transmission.

Fig. 1

Patient flow for green patient.

Fig. 2

Patient flow for red patient.

Fig. 3

Fractures treated through trauma pathway.

Fig. 4

Procedures performed through trauma pathway.