Elective Surgery During the Pandemic

Dr. C. Lowry Barnes shares what UAMS is doing when it comes to elective surgeries during the pandemic.
Elective Surgery During the Pandemic
Featured Speaker:
C. Lowry Barnes, MD
C. Lowry Barnes, M.D., is a board-certified orthopaedic surgeon with special interest in the surgery of the hip and knee. He joined the University of Arkansas for Medical Sciences in 2014 as Professor and Chair of the Department of Orthopaedic Surgery, and in 2017, was invested in The Carl L. Nelson, M.D. Distinguished Chair in Orthopaedic Surgery. 

Learn more about C. Lowry Barnes, MD
Transcription:
Elective Surgery During the Pandemic

Michael Carrese (Host):  Doctors in Arkansas have been given the green light to resume performing elective surgeries after Governor Asa Hutchinson lifted restrictions on April 23rd. With us on the podcast today to help you understand what this all means is Dr. C. Lowry Barnes, a Board-Certified Orthopedic Surgeon and Professor and Chair of Orthopedic Surgery at University of Arkansas for Medical Sciences.

This is UAMS Health Talk. I’m Michael Carrese. Dr. Barnes, thanks for joining us today. so, this is obviously good news for patients who have had to put off some important procedures over the last couple of months. Can you start by giving us kind of the overall picture on where things stand with elective surgeries right now at UAMS?

C. Lowry Barnes, MD (Guest):  Sure. So, the governor and the Arkansas Department of Health Released us to start doing elective surgeries on April 27th. We just started today, and May 11th we’re doing 20 outpatient surgeries today. We have eight rooms in our outpatient area where we do surgery. We are only using four of those rooms because we want to make sure that we can appropriately social distance our patients both before surgery and after surgery. So, that means we can spread them out more in the preoperative area. We are not using waiting rooms. Patients will check in downstairs at their car and we will escort them to their preoperative area so they can be made ready for surgery. And then they’ll be discharged to the recovery room and post anesthetic care unit in a similar fashion taken back downstairs to their friend or loved one. Since we don’t have visitors now in our hospital either. Things have changed so much these days. But we are excited about getting started today though. Things are rolling well, and teams are doing a great job.

Host:  So, as a patient, you get into the post anesthesia unit, and you were saying before, just fewer patients so there is more room between each patient and less risk of infection obviously.

Dr. Barnes:  Exactly. Just like we social distance in the community, we want to social distance in our hospital as much as possible also.

Host:  Now are you only doing certain kinds of procedures or talk about that a little bit.

Dr. Barnes:  So, we started with doing just truly outpatient elective procedures. So, those patients, their surgery will not require them to stay overnight at the hospital. In addition, these are patients who are healthy so ASA grades I and II patients which are the healthiest patients according to anesthesia criteria. And these patients by and large do well with outpatient surgery, so we expect them to do well with this approach. Additionally, these patients have testing done with 48 hours of their surgery. So, they are actually tested for COVID. This can be a challenge. We are starting on a Monday. These patients had to be tested on Saturday. So, that means they came to our drive through area and they were tested for COVID and then now will come in for their surgery today.

Host:  I’m sure there are some patients wondering what the testing is like for staff.

Dr. Barnes:  Currently, staff is not being tested unless they had known exposure or have symptoms. We screen every day and have been doing so now for almost, right around 60 days now. When we enter the hospital each morning, we are – we go through a screening process to see that we meet criteria and whether or not we need to be tested.

Host:  So, I want to talk for a second about the folks who are still waiting and what advice you have for them about when you might be going up full steam doing all procedures like you used to do before all of this started? And what kind of communication they should be having with their primary care doctor, specialists or surgeon?

Dr. Barnes:  Sure so they should be visiting with their surgeon’s office. Most likely either their nurse or their scheduling secretary is calling the patients, talking to them, letting them know what’s going on. If not, they can certainly reach out to their surgeon’s office. We’ll be up not so much at full strength but certainly doing all the operations we were doing before within a matter of weeks. We’ve just been released to start doing the inpatient elective surgery and we’ll start that hopefully next week. It will ramp up slowly though. We are very, very careful. We’re making sure that although our COVID volume of patients is very low, we’re making sure that we can segregate those from others in the hospital. So, they will be on – not only on nursing unit that is different and specialized for COVID care, but in the operating room, we have five operating rooms that only patients who have COVID or could have COVID come in in an emergency situation and can’t be tested, those patients would go in to one of those five rooms. So, they are segregated from the population of patients who have no reason that we would suspect COVID or have already been tested negative for COVID.

Host:  Yeah, so it sounds like every possible precaution is being taken.

Dr. Barnes:  We have had a team of experts working around the clock now for two months making sure we do all that we can for the safety of our patients and our staff.

Host:  I imagine the surgeons and all the OR staff must be happy to get back and be helping these folks who’ve had to wait for a while.

Dr. Barnes:  Indeed. We love what we do. We love serving Arkansas and its residents and we are excited about getting started doing again what we love to do.

Host:  Anything else that patients should be thinking about or their family and loved ones about this reopening?

Dr. Barnes:  It will be a little different because families and loved ones won’t be with the patient when they are in the hospital or having their surgery. We don’t have visitors at this time. And that’s for the visitors’ safety as well as for the other patients’ safety because not everyone is tested. We don’t know who might be a carrier that doesn’t have symptoms. And so we want to make sure we limit the exposure as much as possible. And for those patients who get tested prior to their surgery, they need to remember that they should isolate themselves or like quarantine themselves for those two days prior to their surgery after their test to make sure they don’t become exposed to anyone who might have COVID. The more safe precautions we can take, the better off for everyone.

Host:  Yeah, that’s a good point. So, it makes me wonder, is there quarantine protocol for them after they leave the hospital?

Dr. Barnes:  And so not so much after they leave the hospital. Certainly if they develop symptoms then they should call us immediately. When they go home, they’ve had surgery and most patients will self-quarantine a little while just because they are in the recovery phase, so they’ll be at home for a few days anyway.

Host:  Well listen Dr. Barnes, I’m happy that you folks are able to get back to doing what you do best. And I want to thank you for spending time with us today.

Dr. Barnes:  Well thank you very. Have a great day.

Host:  You’ve been listening to Dr. C. Lowry Barnes a Board-Certified Orthopedic Surgeon and Professor and Chair of Orthopedic Surgery at University of Arkansas for Medical Sciences. For more information on Dr. Barnes or elective surgery at University of Arkansas for Medical Sciences, you can visit www.uamshealth.com. If you found this podcast helpful, please share it on your social channels or check out the full podcast library for additional topics that may be of interest to you. This has been UAMS Health Talk. Thanks for listening.