Sign language for surgeons in the COVID-19 pandemic

• Francisco Alberto Leyva-Moraga Department of Medicine and Health Sciences, Universidad de Sonora, Hermosillo, México.
• Eduardo Leyva-Moraga Department of Medicine and Health Sciences, Universidad de Sonora, Hermosillo, México.,
• Fernando Leyva-Moraga Department of Medicine and Health Sciences, Universidad de Sonora, Hermosillo, México., 
• Abelardo Juanz-González Department of Surgery, Hospital General del Estado de Sonora, Hermosillo, México. ,
• Jorge Arturo Barreras-Espinoza, Department of Surgery, Hospital General del Estado de Sonora, Hermosillo, México.,
• Ahmed Soualhi, GKT School of Medical Education, King’s College London, London, UK.,
• Jesús Antonio Ocejo Gallegos, Department of Medicine and Health Sciences, Universidad de Sonora, Hermosillo, México,
• Martyn Urquijo, Department of Surgery, The University of Arizona Banner Health, Tucson, Arizona.
• Jesús Martín Ibarra Celaya, Thoracic Surgery Department, Hospital +Querétaro, Querétaro, México.

A COVID challenge

One of the consequences of COVID-19 has been greater attention on the risks of infection to clinicians. Much has been made of the need for personal protective equipment, including FFP3 masks, visors, and respirator hoods. Unfortunately these can also impact on communication. This can be due to muffled speech, or loss of ability to read lips. This is important in an operating theatre, where clear communication is critical.

Experience suggests that surgeons probably use some gestures to aid communication when operating. The use of sign language in clinical settings has been previously addressed in the literature, mainly as a proposal to manage increased noise levels in the OR. Sign language has also been suggested as an alternative to handle language differences in surgical team members of varied nationalities, as well as to improve action response within a procedure.

A new sign-language?

To reduce verbal communication that may be limited by impaired speech or hearing, the authors have proposed a surgery-specific sign language. The vocabulary consists of technical information that is easy to learn and replicate and allows fluent communication in the OR. These are summarised in the video above.

A full version of this article can be found in special correspondence to the editor on the BJS website.