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editorial
. 2020 May;54(3):223–227. doi: 10.5152/j.aott.2020.20166

Table 1.

Management of orthopedics and traumatology patients during SARS-Cov-2 pandemic (7, 18, 24–30)

Preoperative period Perioperative surgery staff and perioperative surgery nurses Scrub nurse and OR technician Anaesthesiology specialist and technician OR technician
COVID-19 (+,?) COVID-19 (−) Prepares for surgery,

  • Fluoroscopy and lead jackets, tourniquet, etc.

  • PPE are donned

  • Supervisor/nurse checks PPE

 They should follow the Turkish Health Ministry COVID -19 guidelines for OR and anesthesiology Provide the equipment which will be used during surgery
Isolated ward/PACU/ICU Orthopedic ward
PPE1 PPE2
Intraoperative period Surgeon takes precautions to shorten the time of surgery.

  • Avoids large exposures

  • Minimal invasive surgery if possible.

  • The equipment which is needed during surgery is provided by OR technician

  • Doors will be closed. OR must have negative air pressure or 20 cycle/hour air exchange, HEPA filters and airflow measures must be taken.

Surgeon as team leader, should check all the environmental factors and supervises the high-risk patients.
Postoperative period

  • OR staff and anaesthesiology team will transfer the patient to either bed or PACU. If the patient goes to ICU, the ICU staff must be informed.

  • OR staff including surgical team should follow appropriate doffing guidelines for PPE in designated areas

  • Hand sanitation (hand and forearm wash with soap for 20 seconds or alcohol-based sanitizer) before and after each procedure

  • There must be a separate OR within short reach dedicated to COVID-19

DISINFECTION

  • OR’s walls, floor, trolley and the places which are contaminated with body fluids must be disinfected by 1/100 sodium hypochlorite cas no:7681-52-9 chlorine tablet, %70 alcohol

  • If there is plasma air sterilizer, the room must be sterilized for one hour. Otherwise the OR must be sterilized using ultraviolet light

  • Disposable equipment use must be encouraged
Clinical follow-up and rehabilitation period

  • The follow up of the patient must be done under the PPE protocols.

  • DVT prophylaxis must be performed with LMWH.

  • If the test results are positive other relevant disciplines must be involved

  • While in ICU healthcare personnel should use appropriate PPE1

PPE: personal protective equipment. Referred to flowchart for PPE1 and PPE2; PACU: post-anesthesia care unit; ICU: intensive care unit; OR: operating room; DVT: deep vein thrombosis; LMWH: low-molecular-weight heparin