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2020 ; 18
(6
): e67-e71
Nephropedia Template TP
gab.com Text
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English Wikipedia
A protocol for wide awake local anaesthetic no tourniquet (WALANT) hand surgery
in the context of the coronavirus disease 2019 (COVID-19) pandemic
#MMPMID32631702
Hobday D
; Welman T
; O'Neill N
; Pahal GS
Surgeon
2020[Dec]; 18
(6
): e67-e71
PMID32631702
show ga
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.