Main Article Content
COVID-19, public-health, Emergency room, management, critical issues, pandemic, redeployment
Background and aim: to gain experience and highlight any margins for improvement, we outlined the role played by specialist surgeons (with particular reference to orthopedic surgeons), redeployed in treating COVID-19 patients in the Emergency Department of a general hospital, with severe overcrowding due to the massive and continuous arrival of patients
Methods: “on the field” experience of the Authors is reported, followed by a narrative review of the literature, mainly on the topic of health-personnel redeployment during an emergency
Results: a brief chronological discussion of the progressive reorganization of the hospital, in relation to the progress of the epidemic in the area, is reported, with specific reference to the experience of orthopedic and other branches specialist surgeons, that was characterized by a high degree of uncertainty about what to do, worsened by organizational difficulties due to the incessant arrival of patients and subsequent overcrowding. Observations relating to the critical aspects that have emerged and the various solutions proposed or implemented, if they have been identified, as well as the problems still open, are then made and compared to current literature.
Conclusions: The most significant aspect that we have tried to outline is the organizational difficulty, due to the rapid and unpredictable change in the situation: greater efficiency and flexibility, seen as the ability to overcome bureaucratic, logistical, regulatory or budgetary obstacles that prevent the rapid changes made necessary by the epidemic, could perhaps help to face better any subsequent pandemic wave, like the fierce one ongoing at the present moment
2. Puddu L, Molinari M, Cont F, et al. Noi, ortopedici ai tempi dell’emergenza sanitaria COVID-19. G Ital di Ortop e Traumatol. 2020;(46):109-114.
3. Congiusta D V., Otero K, Ippolito J, Thomson J, Beebe KS. A New Role for Orthopaedic Surgeons: Ongoing Changes, Lessons Learned, and Perspectives from a Level-I Trauma Center During the COVID-19 Pandemic. J Shoulder Elb Surg. July 2020. doi:10.1016/j.jse.2020.07.020.
4. DePeralta DK, Hong AR, Choy C, et al. Primer for intensive care unit (ICU) redeployment of the noncritical care surgeon: Insights from the epicenter of the coronavirus disease 2019 (COVID-19) pandemic. Surg (United States). 2020;168(2):215-217. doi:10.1016/j.surg.2020.05.010.
5. An TW, Henry JK, Igboechi O, et al. How Are Orthopaedic Surgery Residencies Responding to the COVID-19 Pandemic? An Assessment of Resident Experiences in Cities of Major Virus Outbreak. J Am Acad Orthop Surg. 2020;28(15):e679-e685. doi:10.5435/jaaos-d-20-00397.
6. Ranieri D. Coronavirus, i 47 giorni che hanno stravolto l’Italia. Il Fatto Quotidiano. https://www.ilfattoquotidiano.it/in-edicola/articoli/2020/03/16/coronavirus-i-47-giorni-che-hanno-stravolto-litalia/5737766/. Published 16/03/2020.
7. Giorgi PD, Gallazzi E, Capitani P, et al. How we managed elective, urgent, and emergency orthopedic surgery during the COVID-19 pandemic. Bone Jt Open. 2020;1(5):93-97. doi:10.1302/2046-3758.15.BJO.
8. Benazzo F, Marco S, Rossi P, et al. The orthopaedic and traumatology scenario during Covid-19 outbreak in Italy: chronicles of a silent war. Int Orthop. 2020;(44):1453-1459. doi:10.1007/s00264-020-04637-3/Published.
9. Mannucci E, Nreu B, Monami M. Factors associated with increased all-cause mortality during the COVID-19 pandemic in Italy. Int J Infect Dis. 2020;98:121-124. doi:10.1016/j.ijid.2020.06.077.
10. Macrì E, Gariglio MG. Profili di responsabilità civile e assicurativi degli ortopedici nell’emergenza COVID-19. G Ital di Ortop e Traumatol. 2020;(46):103-108. doi:10.32050/0390.
11. Kidd VD. Redeployment of Orthopaedic Advanced Practice Providers at Academic Medical Centers During the COVID-19 Pandemic. Orthop Nurs. 2020;4(39):215-217. doi:10.1097/01.JAA.0000481408.81044.4e.
12. Hourston GJM. The impact of despecialisation and redeployment on surgical training in the midst of the COVID-19 pandemic. Int J Surg. 2020;78:1-2. doi:10.1016/j.ijsu.2020.03.082.