BREAK UP OF CENSUS OF HAND INJURY SERVICES OFFERED AT IRRH&DPS DURING COVID-19 PERIOD

The world has undergone an apocalyptic change due to the Covid-19 Pandemic. Every single sphere of life has seen upheaval leading to major changes in the way we live. There is now a “new normal” that has been mandated by the pandemic and that “new normal” needs to be accepted and adhered to by every one of us.

The Healthcare Services, like the other “Frontline Services”, have continued to work through this phase, but with the necessary changes required to make it safe for all concerned.

The Institute of research and rehabilitation of hand and Department of plastic surgery, as part of the essential services, has continued to work through this uncertain period, caring for patients needing emergency hand injury services and other types of emergency surgeries that could not be delayed.

Now that the lockdown is gradually being lifted, all Routine and Emergency Surgical Services are available as before. However, in the interest of Patient Care and safety and also to safeguard the Doctors, Nurses, and other Healthcare workers, certain changes have been implemented in the working pattern. Some of these changes will be very obvious (PPEs) while others might not be that obvious.

Outpatient Department

On reaching the hospital, you will have to get the Out patient ticket from the issuing counter and then come to the department of plastic surgery (Block number 701).While entering through the Patient entry area a staff will triage you for any potential Covid19 symptoms-if there are any such symptoms, you will be led to the isolated part of the hospital, where your doctor will see you. Those without any such symptoms will be guided to the OPD area reception.

Here, you will go through the following steps:

• Registration

• Ushered to the waiting area: Where you will be requested to await your turn to see the Surgeon. Sitting norms have changed as you will notice to allow for Social Distancing.

• Consultation with the Surgeon: You may find that the Doctor may change consultation rooms periodically to enable the disinfection of the room. Also, the distances between the table and patient chair will be adjusted to allow for a safe gap. Only one attendee may be allowed into the room with the patient to maintain safe distances. The Surgeon and Nurse will be donning the appropriate face masks and other PPEs as deemed necessary.

Patients at higher risk of cross-infection like patients on chemotherapy and the elderly may be seen on a priority to minimise their risk.

You may find that it may take a little longer to complete the entire process and some steps may appear repetitive. But, these measures are what makes the entire consultation a “Safe Experience” for the patient.   

Note: Our OPD , dressing, physiotherapy, splint and rehabilitation clinics will be functioning on all days except Sundays.

Admission and Inpatient Surgical Care:

Before the day of admission or immediately after admission, a Covid19 test is performed to confirm the absence of a Corona Virus infection. This is necessary to ensure the safety of all personnel involved in patient care should the test be positive, the patient would be isolated as per prevalent guidelines, and the surgery deferred.  

If the surgery is deemed a life-saving emergency procedure, then it is conducted as a high-risk procedure, as there is a greater possibility of post-operative complications in a COVID positive patient.

After admission to the ward, during the routine preoperative period, only 1 attendant should accompany the patient. One change you will see is that all the staff in the hospital will be donning masks mandatorily, in addition to any other PPE.

In the Operation Theatre while you are awake before you are given anaesthesia and at the time when you are being brought out of Anaesthesia after the surgery, you will see Nurses and Doctors in full PPE gear.

This can be a daunting sight but it must also reassure you that no corners are being cut and all steps are being taken as per International Guidelines to ensure Safe Surgery in these Covid19 times.

When you are back in the ward after surgery, you will be encouraged to don a surgical mask at all times. This applies to your attendant too.

Emergency Hand injury Services

All Surgical Emergencies can be handled at IRRH & DPS. The patients would be admitted through the ER and would undergo mandatory testing for Covid19.

However, if the surgery is a life-saving one then the surgery is performed with all necessary PPEs and other protocols, without waiting for the Covid19 results. In the event, if the test is positive, the patient would be treated in the isolation area of the hospital. All treatment protocols and patient care standards remain the same except for the area (isolation) in which the patient is cared for.

This allows for patients to receive lifesaving emergency surgical care without compromising on the safety of the patient or healthcare providers.

Follow up appointment after discharge:

At the time of discharge, you will be given clear-cut instructions on the medication, dressing change instruction review dates, dos, and don'ts, symptoms to watch out for, and the follow-up appointment.

For the follow-up appointment, you can follow the procedure outlined for OPD appointments.

It is the goal of the Department to offer state of the art evidence-based surgical treatments to all patients who necessitate the same, while at the same time ensuring the safety of the patient and all Healthcare providers during and also after the Covid19 crisis.

Remember To Wear Your Mask; Practice Hand Hygiene And Adhere To Social Distancing To Stay Safe At All Times.