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Orthopaedics

1. Introduction

The Orthopaedics Department ensures efficient and quality patient care. It covers various areas, including the Outpatient Department (OPD), emergency services, Operative procedures and Indoor Patients (IPD).

 

2. Orthopedic OPD

2.1 Purpose

• To provide standardized and high-quality musculoskeletal disease care and orthopedic trauma.

 

2.2 Scope

• Patient registration

• Consultation

• Assessment

• Operative Procedures

• Medication dispensing

• Rehabilitation Counselling.

 

2.3 Responsibilities

• Department Head: Oversees the overall operations of the department and ensures adherence to SOPs.

• Orthopaedic Surgeons/ Senior Residents: Responsible for patient diagnosis, treatment planning, and surgical procedures, Medical leaves and fitness of beneficiaries.

• Nurses: Provide bedside care to patients, administer medications, and assist in procedures.

• Physiotherapists and Occupational Therapists: Develop and implement rehabilitation programs for patients.

• Support Staff: Assist with administrative tasks, scheduling appointments, and maintaining

medical records.

 

2.4 Procedures

Activity Responsibility

 

2.4.1 Registration

• Dedicated registration area with clear signage.

• Registration clerks gather patient demographic data and generate OPD No.

 

2.4.2 Patient Assessment

• Doctors perform a comprehensive clinical examination of the musculoskeletal system.

• This may include:

o X-rays and other imaging as needed.

o Laboratory tests for specific conditions.

o Assessment for pain, range of motion, deformity, limp and other factors.

 

2.4.3 Treatment Plan

• Doctors develop individualized treatment plans based on the diagnosis.

• This may include:

o Medication prescriptions.

o Physical therapy referrals.

o Casting or splinting.

o Surgical procedures (discussed in section 3).

 

2.4.4 Medication Dispensing

• Pharmacists dispense medications according to doctor's orders.

• Patient education on medication use and potential side effects is provided.

 

3. Emergency Services:

3.1 Purpose

• To provide prompt and effective care for patients with musculoskeletal emergencies and

Orthopaedic Trauma Patient.

3.2 Scope

This SOP outlines procedures for handling various orthopedic emergencies, including:

• Fractures

• Dislocations

• Soft tissue injuries

• Compound Injuries

• Joint pain

 

3.3 Responsibilities

• Emergency/Casualty Doctors and Staff: Initial assessment, stabilization, and pain management, Medico legal/MLC procedures and Specialist/Senior resident consultation as and when required for the same.

• Orthopedic Doctors: Diagnosis, treatment plan development, and potentially performing emergency procedures.

• Nurses: Assisting doctors and providing patient care.

• Pharmacy/Store: Implant procurement /Instruments, etc.

 

3.4 Procedures

• Upon arrival, emergency room Doctor and staff assess the patient's condition and do the triage if necessary.

• Orthopedic doctors are consulted by CMO for definitive diagnosis and treatment plan.

• Treatment may involve:

o Immobilization (casting, splinting)

o Pain medication

o Reduction of fractures/dislocations

o Emergency surgery (discussed in section 4)

 

4. Orthopedic Operation Theatre (OT):

• To ensure safe, aseptic, sterile surgical environment and efficient management of musculoskeletal/Trauma care procedures.

 

4.2 Scope

This SOP defines protocols for pre-operative, operative, and post-operative care for surgical patients.

4.3 Responsibilities

• Surgeons: Performing surgeries and overseeing patient care.

• Anaesthesiologists: Administering anaesthesia and monitoring patients during surgery.

• Nurses: Preparing the operating room, assisting surgeons, and providing post-operative care.

• Supporting Staff: Sterilization, instrument preparation, and maintaining aseptic technique.

 

4.4 Procedures

Pre-operative

• Pre-operative assessments are performed, including:

o Blood tests

o Imaging studies

o Anesthetic evaluation {PAC)

• Informed consent is obtained from the patient.

• Surgical site is prepared.

Operative

• Surgeons perform the necessary procedures using absolute sterile techniques.

• Anesthesiologists monitor vital signs and adjust anesthesia as needed.

• Nurses assist surgeons and ensure proper instrument use and sterile environment.

Post-operative

• Patients are monitored for recovery in the Post-Anesthesia Care Unit (PACU).

• Pain management is addressed.

• Doctors provide post-operative instructions.

5. Inpatient Department {IPD):

1. Admission: Patients admitted for surgery or requiring inpatient care undergo a thorough assessment by a surgeon and nurse.

2. Pre-operative Care: Nurses perform pre-operative assessments, educate patients about surgery, and obtain informed consent.

3. Surgery: Orthopaedic surgeons perform surgical procedures in designated operating theatres following established protocols.

4. Post-operative Care: Nurses provide pain management, monitor vital signs, and assist patients with mobility and rehabilitation.

5. Physiotherapy and Occupational Therapy: Therapists work with patients to regain strength, improve mobility, and restore function.

6. Discharge Planning: The discharge plan is developed considering the patient's progress and includes follow-up instructions and medication management.

Communication:

• Clear communication is maintained between all staff members involved in patient care.

• Daily rounds are conducted by surgeons to discuss patient progress and plan further treatment.

• Detailed patient records are maintained in patient file and electronically in HIS Dhanwantri and accessible to authorized personnel.

Last updated / Reviewed : 2024-07-11