A safe approach to percutaneous tracheostomy for COVID-19 patients in intensive care.
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Authors
Ahmad, Ebrahim
Bright, Michael
Chachlani, Menka
Jolly, Karan
Misurati, Mohammad
Issue Date
2021-04-24
Journal
Type
Article
Peer-Reviewed Publication
Peer-Reviewed Publication
Keywords
Airway management
Clinical practice
COVID-19
Critical care
Difficult airway management
ENT procedures
Health care professionals
Intensive care
Operator safety
Peer-reviewed article
Percutaneous tracheostomy
Pulmonary critical care
Systematic review
Technical report
Tracheostomy
Ventilation
Clinical practice
COVID-19
Critical care
Difficult airway management
ENT procedures
Health care professionals
Intensive care
Operator safety
Peer-reviewed article
Percutaneous tracheostomy
Pulmonary critical care
Systematic review
Technical report
Tracheostomy
Ventilation
Journal Title
Cureus
Volume
13
Issue
4
Begin page
e14663
End page
Abstract
The 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.
Citation
Chachlani 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.