Id |
Subject |
Object |
Predicate |
Lexical cue |
T140 |
0-10 |
Sentence |
denotes |
Discussion |
T141 |
11-278 |
Sentence |
denotes |
In view of the current health crisis due to COVID-19, the suspension of elective surgery and all non-urgent activities is a fundamental measure both to limit the spread of the infection and to relocate medical and nursing staff to COVID-19-dedicated departments [18]. |
T142 |
279-436 |
Sentence |
denotes |
Other fundamental measures are the drafting of precise national and intra-hospital protocols, the training of personnel, and the supply of all necessary PPE. |
T143 |
437-638 |
Sentence |
denotes |
Nonetheless, there are still significant differences between protocols in different countries regarding the organization of departments, patient management, and rules for healthcare professionals [19]. |
T144 |
639-872 |
Sentence |
denotes |
Orthopaedic surgeons are at the forefront of this emergency, and numerous cases of SARS-CoV-2 infection have been recorded among them; a Chinese study showed an incidence of COVID-19 between 1.5 and 20.7% in eight hospitals in Wuhan. |
T145 |
873-1031 |
Sentence |
denotes |
The most suspected places for exposure to the virus were the wards, public places in hospitals, operating rooms, intensive care units, and outpatient clinics. |
T146 |
1032-1176 |
Sentence |
denotes |
A quarter of the infected orthopaedic surgeons passed on the virus to other people, including family members, friends, colleagues, and patients. |
T147 |
1177-1320 |
Sentence |
denotes |
Severe fatigue has proven to be a risk factor for COVID-19, so an optimal organization of health workers’ shifts is of crucial importance [20]. |
T148 |
1321-1397 |
Sentence |
denotes |
In Italy we are experiencing a high number of COVID-19 deaths among doctors. |
T149 |
1398-1521 |
Sentence |
denotes |
Many surgeons feel exposed to a high risk of contagion, and the supply of PPE is not always adequate in all hospitals [21]. |
T150 |
1522-1651 |
Sentence |
denotes |
Thanks to the organization and protocols described above, the health workers of our unit are provided with all the necessary PPE. |
T151 |
1652-1807 |
Sentence |
denotes |
In addition, since we enabled these measures, we have not recorded new cases of infection among doctors and nurses in orthopedic wards and operating rooms. |
T152 |
1808-2000 |
Sentence |
denotes |
In recent months, due to national measures to contain the infection, road accidents have decreased in Italy, and most of the fractures occur in elderly patients with significant comorbidities. |
T153 |
2001-2071 |
Sentence |
denotes |
These patients are also those most severely affected by COVID-19 [22]. |
T154 |
2072-2282 |
Sentence |
denotes |
Considering the high risk of rapid deterioration of their health conditions [23], it is necessary to carefully evaluate these patients to decide whether or not to undergo surgery for the treatment of fractures. |
T155 |
2283-2543 |
Sentence |
denotes |
The flow chart created by our anaesthesiology team (Fig. 2) is currently guiding us in the management of these patients; the measures we have adopted for our surgical activity are in accordance with the latest indications of the scientific literature [24, 25]. |
T156 |
2544-2680 |
Sentence |
denotes |
Although we do not yet have the numbers to demonstrate the effectiveness of this system, we are recording the data for further analysis. |
T157 |
2682-2693 |
Sentence |
denotes |
Limitations |
T158 |
2694-2750 |
Sentence |
denotes |
We have been adapting to a rapidly changing environment. |
T159 |
2751-2804 |
Sentence |
denotes |
These strategies proved to be practical and feasible. |
T160 |
2805-2887 |
Sentence |
denotes |
Having a well thought plan helps to provide for the most robust response possible. |
T161 |
2888-2945 |
Sentence |
denotes |
However, this strategy has several important limitations. |
T162 |
2946-3033 |
Sentence |
denotes |
First, we have not yet been able to study the effectiveness of our proposed strategies. |
T163 |
3034-3135 |
Sentence |
denotes |
Second, our contingency plan is a temporary emergency plan that could not resist long-scale outbreak. |
T164 |
3136-3249 |
Sentence |
denotes |
This plan was rapidly developed and continues to be modified and updated at “Spedali Civili” Hospital in Brescia. |
T165 |
3250-3434 |
Sentence |
denotes |
Finally, the isolation OR workflow and clinical care guidelines are institution- and department-specific; hence, our recommendations may not be applicable to all healthcare facilities. |
T166 |
3435-3593 |
Sentence |
denotes |
Nonetheless, we thought that it would be useful to share our early experience to help other institutions conducting and adapting such strategies more quickly. |