key: cord-0764215-m4l2wf2p
authors: Salomon, Brett; Howk, Amy; Heidel, Robert; McKnight, C. Lindsay
title: Impact of COVID-19 on Trauma Surgical Education at a Level 1 Trauma Center
date: 2021-05-24
journal: Surgery
DOI: 10.1016/j.surg.2021.05.018
sha: 7fe6fa0d513f3d12e2c3a324f8605f3c5ff2fd7d
doc_id: 764215
cord_uid: m4l2wf2p

BACKGROUND: During the COVID-19 pandemic, trauma presentations to the emergency room decreased across the country. The goal of this study is to analyze the educational impact of COVID-19 on trauma education and training at a level-1 trauma center. METHODS: Trauma patient presentations were analyzed six months prior to a state of Tennessee executive stay-home order and six months following the State executive order. To control for the seasonal trauma volumes an additional six months prior to the executive order was then analyzed comparing month to month. Total number of presentations, demographics, procedures, airway management, and COVID-19 status of patients and residents were analyzed. RESULTS: Number of trauma presentations were sustained following executive orders at our Level 1 trauma center. There was no significant difference in intubations, central line placements, and chest tube placements before and during the pandemic. Blunt trauma decreased following stay-home orders. Of the thirty-six residents, no residents tested positive during the study period. CONCLUSION: Trauma focused surgical education was not affected at an academic level-1 trauma center. Understanding that it is region, city, and hospital specific, this study shows that quality trauma education can continue throughout the COVID-19 pandemic while keeping trainees safe. Proper airway management, personal protective equipment, social distancing, and COVID-19 preventative protocols seem to protect residents from potential harm while allowing them to participate and continue in quality trauma education and training.

Introduction on trauma education. This is a retrospective review of the impact of COVID-19 on trauma 74 education. The number of trauma patient presentations, performed procedures, and trips to the 75 operating room on initial presentation for six months following stay-home orders and six months 76 prior stay-home orders will be examined. The data will also be compared to the previous year. 77

We hypothesize that there will be no difference in trauma educational opportunities following 78 stay-home orders. Demographic information was available for each patient including age, sex, and race. 90 COVID-19 status was recorded for each patient that was tested during the study period. 91

Patients who could possibly undergo an operation or had positives on COVID-19 screening 92 were tested for COVID-19. Patients that were not admitted, had a negative screening, or were 93 not undergoing an operation were not tested. 94 residents, attending physician, respiratory therapists, and nurses. Rapid sequence intubation 104 was performed using a video laryngoscope. If the negative pressure room was occupied then 105 back up negative pressure rooms were assigned by the core trauma nurse. If all negative 106 pressure rooms were occupied, then a designated sheltered location outside of the ER was 107 assigned. 108

Resident education at our institution had notable changes during the pandemic. Most 109 conferences were held virtually. The few in-person conferences had a cap on the number of 110 attendants in order to adhere to social distancing guidelines. The simulation lab had a cap on 111 the number of attendants as well as mandatory masks and gloves when training. Our institution 112 fortunately had the resources and personnel to cover the emergency department and COVID-19 113 units without assistance from surgery residents; therefore, surgery residents remained on 114 trauma and surgery rotations. J o u r n a l P r e -p r o o f 

The severe acute respiratory syndrome coronavirus 314 in tears

Novel Coronavirus disease 2019 (COVID-19): The 318 importance of recognizing possible early ocular manifestation and using protective 319 eyewear