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Травматология и ортопедия России. 2020; 26: 15-19

Вызов COVID-19: что сделано и что надо сделать?

Беленький И. Г.

https://doi.org/10.21823/2311-2905-2020-26-2-15-19

Аннотация

Изложена последовательность внедрения системных мер по борьбе с пандемией COVID-19 в России. Обобщен опыт других стран по оказанию специализированной травматологической помощи в условиях пандемии. Практически повсеместно жесткие меры по профилактике и лечению инфекции вводились поэтапно. На сегодняшний день общепринятыми мерами следует считать отказ от плановых хирургических вмешательств, скрининг экстренных больных на COVID-19 с последующим разделением потоков, максимальное сокращение сроков пребывания в стационаре. При этом особое внимание следует уделять средствам индивидуальной защиты персонала. Описаны организационные и лечебные мероприятия, которые необходимы для предотвращения развития подобных пандемий в будущем. Для этого целесообразно оборудование санпропускников, создание запаса средств индивидуальной защиты и дезинфицирующих средств, разработка плана трансформации многопрофильных больниц в учреждения для работы с инфекционными больными с выделением поста первичного приема пациентов и последующим распределением их по потокам в «зелёную» или «красную» зоны. Обоснованы важность сокращения дооперационного койко-дня и внедрения технологий телемедицины и необходимость увеличения финансирования здравоохранения для решения поставленных задач.
Список литературы

1. Zhu W., Li X., Wu Y., Xu C., Li L., Yang J. et al. Community quarantine strategy against coronavirus disease 2019 in Anhui: an evaluation based on trauma center patients. Int J Infect Dis. 2020 Apr 10;96:417-421. doi: 10.1016/j.ijid.2020.04.016. [Epub ahead of print].

2. JainV.K., Vaishya R. COVID-19 and orthopaedic surgeons: the Indian scenario. Tropical Doctor. 2020;50(2):108-110. doi: 10.1177/0049475520921616.

3. Sornsa-Ard T., Niramitsantiphong A., Liawrungrueang W. Management of Traumatic Spinal Fracture in the Coronavirus Disease 2019 Situation. Asian Spine J. 2020 Apr 24. doi: 10.31616/asj.2019.0183. [Epub ahead of print].

4. Tay K.J.D., Lee Y.H.D. Trauma and orthopaedics in the COVID-19 pandemic: breaking every wave. Singapore Med J. 2020 Apr 21. doi: 10.11622/smedj.2020063. [Epub ahead of print].

5. Placella G., Salvato D., Delmastro E., Bettinelli G., Salini V. CoViD-19 and ortho and trauma surgery: The Italian experience. Injury. 2020 Apr 15. doi: 10.1016/j.injury.2020.04.012. [Epub ahead of print].

6. Massey P.A., McClary K., Zhang A.S., Savoie F.H., Barton R.S. Orthopaedic Surgical Selection and Inpatient Paradigms During the Coronavirus COVID-19 Pandemic. J Am Acad Orthop Surg. 2020;28(11):436-450. doi: 10.5435/JAAOS-D-20-00360.

7. Awad M.E., Rumley J.C.L., Vazquez J.A., Devine J.G. Perioperative Considerations in Urgent Surgical Care of Suspected and Confirmed COVID-19 Orthopedic Patients: Operating rooms protocols and recommendations in the Current COVID-19 Pandemic. J Am Acad Orthop Surg. 2020;28(11):451-463. doi: 10.5435/JAAOS-D-20-00227.

8. Stinner D.J., Lebrun C., Hsu J.R., Jahangir A.A., Mir H.R.The Orthopaedic Trauma Service and COVID-19 – Practice Considerations to Optimize Outcomes and Limit Exposure. J Orthop Trauma. 2020 Apr 13. doi: 10.1097/BOT.0000000000001782. [Epub ahead of print].

9. Menendez M.E., Jawa A., Haas D.A., Warner J.J.P. Orthopedic surgery post COVID-19: an opportunity for innovation and transformation. J Shoulder Elbow Surg. 2020;29(6):1083-1086. doi: 10.1016/j.jse.2020.03.024.

Traumatology and Orthopedics of Russia. 2020; 26: 15-19

COVID-19 Challenge: What Has Been Done and What Must Be Done?

Belenkiy I. G.

https://doi.org/10.21823/2311-2905-2020-26-2-15-19

Abstract

The sequence of systemic measures to combat the COVID-19 pandemic in Russia is described. Some other countries experience of providing the specialized trauma care in a pandemic has been summarized. Almost everywhere, strict measures of infection prevention and treatment were introduced in stages. To date, there are the following generally accepted measures: discontinuation of planned surgeries, screening of emergency patients on COVID-19 with the subsequent separation of patient flows, the maximum reduction of hospital stay length. The special attention should be paid to personal protective equipment. The organizational and medical measures necessary for prevention of such pandemics in the future are described, namely equipping sanitary triage posts, creating a stock of personal protective equipment and disinfectants, developing a plan for transforming general hospitals into hospitals for infectious patients with the allocation of a primary patient reception post and their subsequent distribution into the green or red zones. The importance of pre-operative bed day reduction, telemedicine technologies and the need of healthcare financing increase to solve the tasks are substantiated.
References

1. Zhu W., Li X., Wu Y., Xu C., Li L., Yang J. et al. Community quarantine strategy against coronavirus disease 2019 in Anhui: an evaluation based on trauma center patients. Int J Infect Dis. 2020 Apr 10;96:417-421. doi: 10.1016/j.ijid.2020.04.016. [Epub ahead of print].

2. JainV.K., Vaishya R. COVID-19 and orthopaedic surgeons: the Indian scenario. Tropical Doctor. 2020;50(2):108-110. doi: 10.1177/0049475520921616.

3. Sornsa-Ard T., Niramitsantiphong A., Liawrungrueang W. Management of Traumatic Spinal Fracture in the Coronavirus Disease 2019 Situation. Asian Spine J. 2020 Apr 24. doi: 10.31616/asj.2019.0183. [Epub ahead of print].

4. Tay K.J.D., Lee Y.H.D. Trauma and orthopaedics in the COVID-19 pandemic: breaking every wave. Singapore Med J. 2020 Apr 21. doi: 10.11622/smedj.2020063. [Epub ahead of print].

5. Placella G., Salvato D., Delmastro E., Bettinelli G., Salini V. CoViD-19 and ortho and trauma surgery: The Italian experience. Injury. 2020 Apr 15. doi: 10.1016/j.injury.2020.04.012. [Epub ahead of print].

6. Massey P.A., McClary K., Zhang A.S., Savoie F.H., Barton R.S. Orthopaedic Surgical Selection and Inpatient Paradigms During the Coronavirus COVID-19 Pandemic. J Am Acad Orthop Surg. 2020;28(11):436-450. doi: 10.5435/JAAOS-D-20-00360.

7. Awad M.E., Rumley J.C.L., Vazquez J.A., Devine J.G. Perioperative Considerations in Urgent Surgical Care of Suspected and Confirmed COVID-19 Orthopedic Patients: Operating rooms protocols and recommendations in the Current COVID-19 Pandemic. J Am Acad Orthop Surg. 2020;28(11):451-463. doi: 10.5435/JAAOS-D-20-00227.

8. Stinner D.J., Lebrun C., Hsu J.R., Jahangir A.A., Mir H.R.The Orthopaedic Trauma Service and COVID-19 – Practice Considerations to Optimize Outcomes and Limit Exposure. J Orthop Trauma. 2020 Apr 13. doi: 10.1097/BOT.0000000000001782. [Epub ahead of print].

9. Menendez M.E., Jawa A., Haas D.A., Warner J.J.P. Orthopedic surgery post COVID-19: an opportunity for innovation and transformation. J Shoulder Elbow Surg. 2020;29(6):1083-1086. doi: 10.1016/j.jse.2020.03.024.