After receiving the task of treating the wounded, our medical workers in isolation ward immediately entered the preparation state and improved the training contents, including learning of inpatient environment, use of protective equipment, accountable and overall nursing care plan, related knowledge of the COVID-19, treatment plan, nursing measures and so on [4]. We participate in a week of theoretical and operational training in the orthopedics department, and all the staff were proficient in the key contents such as axis turning method, neck brace fixation, breathing and limb function exercise, and postoperative evaluation and observation. At the same time, medical workers confirmed that the articles in the isolation ward were in emergency and complete state, and determined the inspection route, transportation and operation route, and the main contents of succession.

On the day of admission, the orthopedic doctors worked out the operation method and date based on the results of various examinations. The anesthesiologist completed the preoperative visit and evaluated that the general and endotracheal intubation conditions were good. In the morning of the operation day, after the operation team checked the patients in bed, the operation, anesthesia and nursing teams conducted preoperative discussion. The surgeons and anesthesiologists talked with the family members of the patient after the unified plan. Family members sign the relevant informed consent. The medical staff in the isolation ward completed preoperative fasting and water deprivation, skin preparation, blood matching, oral care, skin care, urethral care, prepared surgical handover record sheet and necessary instruments, and sent the patient to the operating room.

The uncertainty of illness and social isolation are the main reasons for the patients to produce a series of emotional reactions after the patient enter the isolation ward, and the strong emotional reaction causes the body to produce stress response, which is easy to cause anxiety, impatience, pessimism and other negative emotions, resulting in the disorder of autonomic nerve function, the reduction of human immunity, and harmful effect on the outcome and prognosis of the disease [5]. Psychological doctors consult in time, conduct psychological counseling, and explain that rehabilitation training is a gradual process. Under the guidance of medical staff, active exercise can achieve good results. Nursing staff encourage the patient to express his thoughts, listen patiently to the needs, introduce the successful rehabilitation examples of similar diseases in the past, enhance the confidence in rehabilitation, make him actively cooperate with treatment, and improve his psychological disease resistance ability. Nurses should try to communicate with the patient and his families, friends, leaders and other relevant personnel to meet the needs of him as much as possible, so that he can feel the care of his families and friends [6].

The patient returned from Tanzania and had low fever symptoms before, who was isolated as a suspected case according to the epidemiological investigation. After admission, the patient entered the isolation ward from the special channel and treatment was carried out in a single isolation room. Cleaning workers trained by professional personnel carried out cleaning and disinfection work in the isolation ward. Nurses guided the patient to pour 20,000 mg/L chlorine-containing disinfectant into the bedpan for 2 hours after each defecation and urination, and then pour them into the toilet. Relevant guidelines were formulated to inform the patient. The patient must wear a mask during hospitalization, and nurses also guided the wearing method of the mask and assisted the patient to wear it correctly. The air disinfector runs continuously for 24 hours [7].

After admission, closely monitor and record the vital signs, limb muscle strength, feeling, movement and defecaton and urination, pay attention to the occurrence of hypotension and hyponatremia, and monitor the urine volume and urine specific gravity. Focus on whether the patient has the following clinical symptoms and complaints: 1) Whether the patient has fever, fatigue, etc. 2) Patients with pneumonia: cough, expectoration, chest tightness, shortness of breath. 3) Patients with nasal congestion, runny nose, sore throat and diarrhea and other symptoms. 4) Whether the patient has dyspnea or hypoxemia, whether there is cyanosis in the nail bed and lips. 5) Whether the vital signs of patients are stable. Report to the doctor in time in case of any abnormality [7].

The principle of functional exercise is to start as early as possible, step by step, combine the active and passive, and persist for a long time. Without affecting the fixation, the muscles, tendons, ligaments and joint capsules of the affected limb should be recovered as soon as possible [8]. Specific rehabilitation exercise prescriptions were formulated by the orthopedic nursing staff after the ward round, which were assisted by nursing staff in the isolation ward. During the exercise process, the rehabilitation specialist carried out physical therapy such as low-frequency pulse therapy, and the muscle strength was better than before.

Early intermittent catheterization is an important way of bladder training, and is the “gold standard” to assist bladder emptying. Intermittent filling and emptying of bladder contribute to the recovery of bladder reflex. Intermittent catheterization should be started as soon as possible after the patient’s vital signs are stable. The specific method is to open the catheter every 4 hours and adjust the amount of drinking water according to the urine volume. After training, the patient has regained the consciousness of urination, and the inflow and outflow has reached a relatively balanced level, so as to pull out the catheter as soon as possible.

After spinal cord injury, the nervous function of intestinal tract is damaged, and the colonic peristalsis is decelerated, so that the water absorption is more. In addition, the patient’s activity and water intake is reduced, and the stool is harder and more difficult to expel. After the rounds of the nursing staff in the rehabilitation department, massaging the area surrounding anus to pull the anal sphincter is performed [10]. The specific method is to make the patient to take the left lying position and mat treatment towel under his hip, apply paraffin oil to the nurse’s index and middle finger, and then stick slowly the index finger into the anus after massage. Next Expand the anus in the directions of 12, 3, 6 and 9 o’clock (suppose the patient’s spine is in the direction of the clock at 12 o’clock), 10 times in each direction (take out when there is stool in the process of anal dilatation), and then massage clockwise. At the same time, the patient is instructed to eat more food rich in dietary fiber, fresh fruits and vegetables. The result is that the patient can exclude stool.

Intermittent decompression can well prevent pressure sores [11]. The application of local decompression and various decompression equipment is the key. An air cushion bed was used immediately upon admission. Keeping the bed clean and dry, and turning over regularly during the bed rest every 2 hours is also necessary. We also put the patient in the correct position, change the weight support frequently to reduce the pressure, and use soft pillow, sponge pad and other protective equipment [12]. The axis turning method is adopted when turning the body. One needs to fix the head to make it turn with the shoulder at the same time. Before wearing the neck support, the Anpu patch was applied to the inner side of the neck bracket to reduce the friction force when contacting with the skin. The sacral, heel, iliac crest and other pressure parts were externally coated with Saifurun, and the skin of the patient was well protected.

The nucleic acid results of COVID-19 for three consecutive times within 14 days after isolation in our hospital were negative (shown in the Table 3 below), and the patient did not have respiratory tract and other related symptoms, which met the conditions for removing isolation. The medical staff informed the patient of the relevant attention points and knowledge of epidemic prevention and control. The patient was recommended to be transferred to the rehabilitation department for further rehabilitation treatment. The patient in rehabilitation department received treatment such as nerve nutrition, improving circulation, symptomatic relief and supportive treatment, passive joints movement training, hand function training, standing bed training, bladder training, electric acupuncture treatment. His finger flexion and extension abductor strength is restored to level 2, hip flexion strength is restored to level 3, and knee extensor strength is restored to level 4. He could also turn over to both sides independently, and could sit up with a lot of help. The balance of the sitting position could reach level 2. Things are getting better and better.