Percutaneous tracheostomy in COVID-19 patients: The Miami model.
Percutaneous tracheostomy in COVID-19 patients: The Miami model. Respir Med Case Rep. 2020;31:101237 Authors: Akkineni S, Adkinson BC, Arias S Abstract The surge in critically ill patients requiring mechanical ventilation fueled by the COVID-19 pandemic has strained healthcare systems globally. With the increasing need for critical care resources, tracheostomy can facilitate weaning from mechanical ventilation and potentially increase availability of critical care resources. In this case series of three patients, we describe our technique for performing bedside percutaneous tracheostomy on patients with persistently positive SARS-CoV-2 real time polymerase chain reaction (RT-PCR). We hope to provide proceduralists with a specific method for percutaneous tracheostomies that is both safe for the patient and provider. PMID: 33014704 [PubMed]
Conclusion The use of PPE (N95 or powered air-purifying respirator [PAPR]) during procedures should be mandatory. Patients should be evaluated about their COVID-19 status before hospital admission. Cancer should be treated. Tracheostomy tube cuff should be inflated inside the tracheal incision. All COVID-19 precautions should be kept until there is a validated antiviral treatment or an available vaccine. [...] Thieme Revinter Publicações Ltda Rio de Janeiro, BrazilArticle in Thieme eJournals: Table of contents | Abstract | open access Full text
CONCLUSION: Critical care nurses and multidisciplinary teams often care for patients with a tracheostomy who are known or suspected to have COVID-19. Appropriate care of these patients relies on safeguarding the health care team. The practices described in this review may greatly reduce risk of infectious transmission. PMID: 32929453 [PubMed - as supplied by publisher]
In Reply We thank Cazzador et al for their appreciation of the Viewpoint “Surgical Considerations for Tracheostomy During the COVID-19 Pandemic: Lessons Learned From the Severe Acute Respiratory Syndrome Outbreak.” Since the publication, several other groups have also developed guidelines for tracheostomy in the context of coronavirus disease 2019 (COVID-19), with si milar goals of minimizing perioperative aerosolization risks.
To the Editor Tay et al should be complimented on their Viewpoint “Surgical Considerations for Tracheostomy During the COVID-19 Pandemic: Lessons Learned From the Severe Acute Respiratory Syndrome Outbreak” highlighting preoperative and perioperative recommendations for tracheostomy during the coronavirus disease 2019 (COVID-19) pandemic. The authors searched the literature for tracheostomies performed during the previous outbreak of severe acute respiratory syndrome (SARS), finding 3 case series and 2 case reports (23 procedures). Lessons learned from those experiences were summarized into 5 points. The need f...
ConclusionsIt is feasible to perform PDT on intubated COVID-19 patients using the AerosolVE negative-pressure tent. This is a promising low-cost device to decrease risk to healthcare providers during AGPs.
CONCLUSIONS: Tracheostomies on COVID-19 patients should be performed in a safe and standardized setting. The limited resources available in the pandemic peak required meticulous organization and optimal allocation of the resources to grant safety of both patients and healthcare workers. PMID: 32741194 [PubMed - as supplied by publisher]
CONCLUSIONS: The procedure described was successful in our patient population. We believe that this approach is safe for patients with coronavirus disease 2019 and limits aerosolization during the operation. LEVEL OF EVIDENCE: Level IV, case series. PMID: 32722924 [PubMed - as supplied by publisher]
Abstract The novel corona virus disease (COVID-19) has unfolded into a pandemic and is continuing to propagate at a frightening speed. The aim of this article is to share our protocol for performing a safe surgical tracheostomy in this COVID-19 era. Tracheostomy procedures have a high risk of aerosol generation. To standardize institutional safety measures with tracheostomy, we advocate using a dedicated tracheostomy protocol applicable to all patients including those suspected of having COVID-19. We also did explore the current literature and recommendations for tracheostomy in patients with COVID-19 and studied the previ...
Conclusions Speech-language pathologists are often called on to assist in the care of patients with tracheostomy and known or suspected COVID-19 infection. Appropriate care of these patients is predicated on maintaining the health and safety of the health care team. Careful adherence to best practices can significantly reduce risk of infectious transmission. PMID: 32525695 [PubMed - as supplied by publisher]
CONCLUSION: Our data, together with the current literature, clearly emphasize that tracheostomy care is associated with a high infection risk and should only be performed by a small group of well-trained, maximally protected healthcare personnel. PMID: 32514605 [PubMed - as supplied by publisher]