Protection of Medical Staff during Tracheotomy: Lessons Learned from the COVID-19 Pandemic

Background: During the ongoing pandemic of COVID-19, tracheotomy under emergency situation is considered a high-risk procedure that causes probable expose to aerosolized secretion.Summary: We reviewed our case and previous reports, and summarized a detailed protocol that is needed to protect medical staffs who perform tracheotomy under the COVID-19 pandemic, considering the patient ’s condition, experience of medical staff members, and available facilities and equipment.Key Messages: For efficient protection of medical staff who perform tracheotomy under the COVID-19 pandemic period, we suggest that the following needs to be considered: assessment of patient ’s condition (COVID-19 infection and the airway problem), route (safest route to the operating room), experienced surgical team, negative-pressure isolation facility and appliance (personal protective equipment) availability, and safe and appropriate post-tracheotomy care.ORL
Source: ORL - Category: ENT & OMF Source Type: research

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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 ...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Respir Med Case Rep Source Type: research
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
Source: International Archives of Otorhinolaryngology - Category: ENT & OMF Authors: Tags: Systematic Review Source Type: research
Up to June 2020, 232 patients were admitted to Intensive Care Units (ICU) at King ’s College Hospital (KCH), London due to COVID-19. Our Oral and Maxillofacial Surgery Unit received 51 referrals for surgical tracheostomies. With 96231 admissions to ICU nationally, there was a shortage of the commonly used Tracoe® twist tracheostomy tubes (Tracoe Medical, GmbH) with inner and o uter cannulas and a subglottic suctioning port.
Source: The British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Tags: Technical note Source Type: research
AbstractAt this moment the world is fighting with COVID-19 pandemic. Because of increasing number of critical cases, the ICU admissions are also increasing and overwhelming the hospital. These group of patients often required Tracheostomy for proper management and ventilation. As Surgeons we often required to examine and perform procedures in head and neck patients and are in high risk of exposure to aerosol and droplet contamination. We did a literature search for research regarding tracheostomy and its post procedure care during the ongoing COVID-19 pandemic. In this review various international guidelines and sources we...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research
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]
Source: American Journal of Critical Care - Category: Nursing Authors: Tags: Am J Crit Care Source Type: research
ConclusionThe goal of the guidelines is to make the procedure safer for medical teams, without harming the patients. Further improvements of the guidelines will surely appear as COVID-19 is a new entity and there is not yet much experience in handling it.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
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.
Source: JAMA Otolaryngology - Head and Neck Surgery - Category: ENT & OMF Source Type: research
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...
Source: JAMA Otolaryngology - Head and Neck Surgery - Category: ENT & OMF Source Type: research
During the USNS Comfort mobilization to New York City in response to the pandemic, the ship's medical team cared for over 35 mechanically ventilated corona virus disease 2019 (COVID-19) infected patients. Due to the better than expected mortality rates of these patients, tracheotomy for prolonged intubation or other indicated interventional bronchoscopies were performed on 7 COVID positive patients, as well as 2 with negative screening tests. No member of the health care team subsequently became symptomatic or tested positive for COVID-19. This was in part due to the formation of a dedicated surgical airway team, use of st...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: COVID-19 Educational Supplement (Available for Free) Source Type: research
Publication date: Available online 19 August 2020Source: British Journal of Oral and Maxillofacial SurgeryAuthor(s): A.O. Green, A.D. Chellappah, K. Fan, P.D. Stenhouse
Source: British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research
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