Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic.

Autor: Sommer DD; Division of Otolaryngology - Head & Neck Surgery - Department of Surgery, McMaster University Medical Centre, McMaster University, 3V1 Clinic, 1200 Main St West, Hamilton, ON, L8N 3Z5, Canada. cso.hns@sympatico.ca., Engels PT; Department of Surgery and Critical Care, McMaster University, Hamilton, ON, Canada., Weitzel EK; United States Army Institute of Surgical Research, Fort Sam Houston, TX, USA., Khalili S; Aurora Neuroscience Innovation Institute, Milwaukee, WI, USA., Corsten M; Division of Otolaryngology - Head & Neck Surgery, Dalhousie University, Halifax, NS, Canada., Tewfik MA; Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada., Fung K; Department of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada., Cote D; Division of Otolaryngology - Head and Neck Surgery, University of Alberta, Edmonton, AB, Canada., Gupta M; Division of Otolaryngology - Head & Neck Surgery - Department of Surgery, McMaster University Medical Centre, McMaster University, 3V1 Clinic, 1200 Main St West, Hamilton, ON, L8N 3Z5, Canada., Sne N; Department of Surgery and Critical Care, McMaster University, Hamilton, ON, Canada., Brown TFE; Division of Otolaryngology - Head & Neck Surgery, Dalhousie University, Halifax, NS, Canada., Paul J; Department of Anesthesia, McMaster University, Hamilton, ON, Canada., Kost KM; Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, QC, Canada., Witterick IJ; Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada.
Jazyk: angličtina
Zdroj: Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale [J Otolaryngol Head Neck Surg] 2020 Apr 27; Vol. 49 (1), pp. 23. Date of Electronic Publication: 2020 Apr 27.
DOI: 10.1186/s40463-020-00414-9
Abstrakt: Introduction: The performance of tracheotomy is a common procedural request by critical care departments to the surgical services of general surgery, thoracic surgery and otolaryngology - head & neck surgery. A Canadian Society of Otolaryngology - Head & Neck Surgery (CSO-HNS) task force was convened with multi-specialty involvement from otolaryngology-head & neck surgery, general surgery, critical care and anesthesiology to develop a set of recommendations for the performance of tracheotomies during the COVID-19 pandemic.
Main Body: The tracheotomy procedure is highly aerosol generating and directly exposes the entire surgical team to the viral aerosol plume and secretions, thereby increasing the risk of transmission to healthcare providers. As such, we believe extended endotracheal intubation should be the standard of care for the entire duration of ventilation in the vast majority of patients. Pre-operative COVID-19 testing is highly recommended for any non-emergent procedure.
Conclusion: The set of recommendations in this document highlight the importance of avoiding tracheotomy procedures in patients who are COVID-19 positive if at all possible. Recommendations for appropriate PPE and environment are made for COVID-19 positive, negative and unknown patients requiring consideration of tracheotomy. The safety of healthcare professionals who care for ill patients and who keep critical infrastructure operating is paramount.
Databáze: MEDLINE
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