New approaches in providing care to surgical patients under conditions of COVID-19 pandemic on the basis of Military medical clinical center of Central region

Abstract

Annotation. Nowadays, in coronavirus disease pandemic, the conditions for emergency surgery have changed. The aim of the work was to improve the provision of emergency surgical care under conditions of COVID-19 pandemic by developing and implementing clinical pathway of patients, using the remodeled infectious disease unit with a specially equipped operating room. To improve emergency surgical care under conditions of coronavirus pandemic, clinical pathways have been developed and implemented for management of patients with acute surgical pathology: the pathway of the patient requiring emergency surgery with suspected COVID-19 during self-presentation, the patient delivered by ambulance, in mass admission of patients, in admission of servicemen. Part of the hospital stock was restructured into isolated off-line infectious disease unit for treatment of patients with COVID-19 in a separate two-story building. Specially equipped operating room of the off-line infectious disease unit has separate entrances for patients and medical staff, which ensures the distribution of patient flows in the operating room. Clinical pathways for providing emergency care to patients with acute surgical pathology, developed by the authors, made it possible to divide them into flows and minimize possible risks of coronavirus infection in medical staff and other groups of patients. Under pandemic conditions, restructuring of hospital stock along with creation of off-line units with the use of existing staff seems to be warranted. Appropriate training of medical personnel in the restructured units working with COVID-19 infection as well as the development of rotational system mechanism for medical personnel are urgently required. Clinical results of treatment of patients with acute surgical pathology in the off-line infectious disease unit for patients with COVID-19 will be the object of future studies.