Orthopaedic Surgery in the Era of COVID-19 – Ventilators

Orthopaedic & Spine Center
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Spine Surgery - Dr. Carlson in the ORJeffrey R. Carlson, MD

Thus far, 2020 has been a year in which we have seen extraordinary changes in our lives due to the Coronavirus pandemic. Pretty much everything we do has been altered or impacted by our need to minimize the spread of this deadly virus.  These changes have affected the practice of medicine and surgery in significant ways as well. In this article, I will address one of the ways surgery has changed due to the COVID-19 virus and what we do in the operating room to lessen the exposure of our patients, as well as the surgical team and hospital personnel. A glimpse behind the scenes at the hospital OR…

For many orthopaedic procedures, such as joint replacements and spine surgery, patients are placed on a ventilator so their breathing can be safely controlled while they’re under anesthesia.  Ventilators have certainly been in the news recently, as they have been used extensively for critically ill COVID-19 patients.  The concern about the availability of ventilators for COVID-19 patients was one of the main reasons all elective surgeries were postponed until each locality passed its peak of COVID-19 cases.  Before COVID-19, the patient would be intubated by the anesthesia team with all OR personnel standing by in the room.

Even though all surgical patients are tested for COVID-19 before surgery, for everyone’s safety, we must treat them as though they could potentially transmit the virus. We understand that COVID-19 is transmitted through droplets from the respiratory tract.  Once considered routine, intubation for assisted ventilation has become a hazardous procedure, as the insertion of the breathing tube exposes the OR team to exhalation droplets and mucus excretions from the patient. As a result, only the anesthesia team is allowed in the OR while this very necessary procedure is completed, which then allows surgery to begin.

 

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