A safe approach to percutaneous tcheostomy for COVID-19 patients in intensive care.
TypeClinical Practice; Peer-Reviewed Publication; Technical Report
KeywordPulmonary critical care; Difficult airway management; Operator safety; Health care professionals; ENT procedures; Percutaneous tracheostomy; Intensive care; COVID-19; Ventilation; Critical care; Airway management; Tracheostomy
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AbstractThe novel coronavirus disease 2019 (COVID-19) has placed a burden on critical care facilities worldwide. Patients who remain critically unwell with COVID-19 require prolonged periods of ventilation, and the burden of both the resources during a pandemic and the slow respiratory wean must be managed. Percutaneous tracheostomies are commonplace in long-term intensive care patients, yet little is known about their role in COVID-19, particularly how operator safety is maintained during the procedure. Here, we describe an approach designed to minimize cross-infection of the operators undertaking percutaneous tracheostomies within this subset of patients. Focus should be on non-technical skills, prolonged periods of pre-oxygenation, and minimal ventilation during the procedure to minimize the risk of aerosolization generated from an open breathing system. Our modified technique demonstrates successful early experiences with no operators testing positive for COVID-19 or developing symptoms following any performed procedure.
CitationChachlani M, Misurati M, Jolly K, Ahmad E, Bright M. A Safe Approach to Percutaneous Tracheostomy for COVID-19 Patients in Intensive Care. Cureus. 2021 Apr 24;13(4):e14663. doi: 10.7759/cureus.14663. PMID: 34055514; PMCID: PMC8148621.
Publisher Linkhttps://www.cureus.com/articles/56868-a-safe-approach-to-percutaneous-tracheostomy-for-covid-19-patients-in-intensive-care; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8148621/
RightsAttribution 3.0 United States
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