Orthopaedic Dispatches from the Front Line

NYU Langone Hospital
April 16, 2020
Jessica Morton, MD, PGY4

I am currently rotating at NYU Langone Hospital in Brooklyn, a 450+ bed academic Level 1 Trauma center. We serve a diverse community that has been hit hard by COVID-19. The hospital has greatly expanded its inpatient and ICU capabilities in response to the increasing need for inpatient beds. The orthopaedic team at NYU—Brooklyn is “all hands on deck” with all members of the team participating in COVID-19 shifts. Members of our team have volunteered in the COVID-19 screening center, participated in the proning teams, and acted as family liaisons. We also joined our medical colleagues caring for patients with COVID-19 in the emergency room, on general medicine floors, and in the COVID-19 ICU.

As a resident, I switch weekly between orthopaedic responsibilities and COVID-19 ICU responsibilities. In the ICU, under the supervision of a critical care attending, I assist in the management of patients who have been placed on ventilators for COVID-19-associated pneumonia and ARDS. These are the sickest patients in the hospital and require frequent attention and interventions whether it’s drawing an ABG or managing electrolytes. Returning to the ICU has been a learning curve made better by the teaching and guidance of our critical care colleagues. I feel proud of our NYU Langone’s Department of Orthopedic Surgery for stepping outside our normal roles and assisting our medical colleagues and our patients fighting COVID-19.

NYU Langone Hospital
April 16, 2020
Anthony Gualtieri, MD, PGY4

I am currently assigned to Bellevue Hospital, an 800+ bed public hospital and one of only two Level 1 Trauma Centers in Manhattan. I alternate every other day between my orthopaedic responsibilities and functioning on the Bellevue “prone team.” COVID-19 patients that develop ARDS can have trouble with lung recruitment if they remain supine for extended periods of time. As such, the ICU team utilizes the prone team to assist in alternating the patient’s position between prone and supine with the goal of improving their oxygenation. It is very similar to positioning for spine surgery, except that it is all done on the same bed, and the patients are much, much sicker. We have two teams, each made up of one attending and three residents, with assistance from an attending anesthesiologist and the patient’s nurse.

The feedback we have received from the ICU staff has been extremely positive, and it seems that this seemingly basic activity is having a positive effect for the patients. I feel proud of the Orthopedic Department at Bellevue Hospital for stepping up and assisting these patients, who are some of the sickest in the hospital.