Orthopaedic services during COVID-19 lockdown at Patan Hospital, Nepal

Abstract

Introduction: The COVID-19 pandemic has paralyzed the world, including elective health care services. To prevent the spread of infection, most countries have gone into lockdown and adjustments have been made to provide urgent medical care, including Orthopaedic services. In accordance with the guidelines from worst affected countries and neighboring India, Patan Hospital followed instructions from Ministry of Health and Population to provide only urgent and semi-urgent Orthopaedic services. This study aims to audit the patient profile during lockdown so as to have a clearer picture, which will enable us to be prepared for similar epidemic in the future.
 Method: All patients admitted to the Orthopaedic ward of Patan hospital from 24 March to 27 April 2020, during the lockdown, were included. Clinical profile, including cause of admission, management, hospital stay were descriptively analyzed. Ethical approval was obtained.
 Result: Out of 44 admissions, there were male 27 and female 17. Trauma cases were 38, and 18 were in age group 20-26 years. Admission due to infections were four. Conservative management were done in seven while 33 were treated surgically, out of which 30 accounted for trauma. Average 6.14 days hospital stay, range 1-22 days.
 Conclusion: Trauma comprised of major bulk of patients seeking urgent Orthopaedic care. Hospital needs to be prepared with necessary measures to ensure safety of health care workers and yet provide urgent Orthopaedic services.

Orthopaedic Services during Nationwide COVID-19 Lockdown: Dhulikhel Hospital, Kathmandu University Hospital Experience and Review

“…They however did not have any cases of RTA owing to the lockdown. 22 Average injury surgery interval for trauma cases was 2.80 ± 3.38 days (range 0-15 days), which is similar to 3.12 days reported by Pradhan et al 22 This interval could be attributed to unavailability of vehicles, difficult terrains, other patients requiring optimization of medical or local condition for surgery and during latter half of lockdown, waiting for preoperative COVID-19 PCR reports. 22 Interestingly enough the average hospital stay for the admitted patients during the lockdown compared to the previous year was not very different.…”

“…22 Average injury surgery interval for trauma cases was 2.80 ± 3.38 days (range 0-15 days), which is similar to 3.12 days reported by Pradhan et al 22 This interval could be attributed to unavailability of vehicles, difficult terrains, other patients requiring optimization of medical or local condition for surgery and during latter half of lockdown, waiting for preoperative COVID-19 PCR reports. 22 Interestingly enough the average hospital stay for the admitted patients during the lockdown compared to the previous year was not very different. Although we have tried to make the hospital stay shorter for all patient by discharging the patient from hospital earlier than we are used to, due to limited number of surgeries, surgeons, anesthetist and other human resources per day, limited number of ICU beds for patients who might have required ICU post-operatively, difficulty in obtaining necessary finances for surgeries due to limited opening of the banks, waiting for the reports of pre-operative nasopharyngeal swab for PCR for COVID-19, and one patient stayed for 89 days despite timely surgery, due to unavailability of vehicles to commute to and from the home.…”

“…21 Similar to our findings, Pradhan et al have stated a decrease in orthopaedic burden at Patan Hospital, Nepal during lockdown to about a third of what they are used to. 22 They reported that 84.1% of admitted cases were trauma and most of them had fallen from standing height. They however did not have any cases of RTA owing to the lockdown.…”

Impact of COVID-19 on Orthopaedic Surgery: Comparison Between Before and During COVID-19 Pandemic

“…Operated spine trauma cases were (10, 6.8%) similar to a study conducted at Patan Hospital, Nepal (2,5%). 19 Fall from height and tree due to increased agricultural activity during pandemic might have contributed to this result. In contrast to our study, a study from Italy showed a 50% reduction in spine trauma surgery.…”

A Cross-Sectional Overview: The Effect of the Covid-19 Pandemic on the Flow Rate of Orthopedic Truama Cases in Kuwait

“…There is yet to be answers to these questions, however, this study offers some insight on the current situation in Kuwait regarding orthopedic injuries. Healthcare systems worldwide are facing challenges that they have never dealt with before [15][16] . In this study, we had lower numbers of the elderly population presenting to our departments.…”