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A protocol for wide awake local anaesthetic no tourniquet (WALANT) hand surgery in the context of the coronavirus disease 2019 (COVID-19) pandemic
- Source :
- The Surgeon
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- There are new and unique challenges to emergency surgery service provision posed by the Coronavirus disease 2019 global pandemic. It is in the best interests of patients for care providers to streamline services where possible to maximise the number of cases that can be performed by limited surgical and anaesthetic teams, as well as minimising patient interactions and admission times to reduce potential spread of the virus. There is evidence that wide awake local anaesthetic no tourniquet (WALANT) hand and upper limb surgery can meet this need in a number of ways, including reduced pre-operative work up, the lack of a need for an anaesthetist or ventilator, shorter inpatient stays and improved cost efficiencies. Though updated national guidelines exist that advocate increased use of WALANT surgery in response to the pandemic there are not yet clear protocols to facilitate this. We outline a protocol being developed at one UK Major Trauma Centre tailored to the expansion of WALANT hand and upper limb emergency surgery with particular emphasis on facilitating timely surgical care while minimising healthcare encounters pre and post-operatively. This will serve to reduce potential transmission of the virus and create cost efficiencies to free funding for COVID-19 related care. Our protocol is easily replicable and may be of benefit to other centres dealing with emergency upper limb surgery in the new climate of COVID-19.<br />Highlights • New protocol for WALANT hand surgery in the COVID-19 pandemic. • Protocol may reduce viral transmission and improve surgical service provision. • Protocol easily replicable in other centres.
- Subjects :
- medicine.medical_specialty
Pneumonia, Viral
Hand surgery
Context (language use)
WALANT
Best interests
Article
Betacoronavirus
Clinical Protocols
Health care
Pandemic
medicine
Humans
Orthopedic Procedures
Service provision
Anesthetics, Local
Pandemics
Personal Protective Equipment
Protocol (science)
Infection Control
Tourniquet
SARS-CoV-2
business.industry
Patient Selection
Major trauma
COVID-19
Tourniquets
Hand
medicine.disease
Surgery
Medical emergency
Coronavirus Infections
business
Anesthesia, Local
Subjects
Details
- ISSN :
- 1479666X
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- The Surgeon
- Accession number :
- edsair.doi.dedup.....a58c456910dd8b7476fb576d95ec22e2