Per-cutaneous dilatation tracheostomy (PCTD) in COVID-19 patients and peri-tracheostomy care: A case series and guidelines
Autor: | Muhammad Anwar Malik, Ehtesham Khan, Shankar Lal, Junaid Hashmi, Jubil Thomas |
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Rok vydání: | 2020 |
Předmět: |
Mechanical ventilation
medicine.medical_specialty Percutaneous Coronavirus disease 2019 (COVID-19) medicine.diagnostic_test business.industry medicine.medical_treatment General surgery Percutaneous dilatational tracheostomy General Medicine Clinical Case Series COVID-19 patients 03 medical and health sciences 0302 clinical medicine Respiratory failure Bronchoscopy Health care Percutaneous tracheostomy Medicine Tracheostomy care 030212 general & internal medicine aerosol generating 030223 otorhinolaryngology business |
Zdroj: | Pakistan Journal of Medical Sciences |
ISSN: | 1681-715X 1682-024X |
Popis: | Background & Objective: COVID 19 patients with severe respiratory failure may require prolonged mechanical ventilation. Placement of a tracheostomy tube often becomes necessary for such patients. The steps of tracheostomy procedure and post tracheostomy care of these patients can be classified as aerosol generating. We wish to highlight our modified technique to address these issues. Methods: We performed percutaneous dilation tracheostomy in three clinically challenging COVID-19 patients in our ICU and developed guidelines aiming to minimise aerosolisation during and after the tracheostomy procedure to safeguard healthcare workers. Results: Percutaneous tracheostomy was performed by a team of three experienced anaesthetists and an ICU nurse. Conclusion: The decision of surgical or percutaneous tracheostomy should be dependent on the experience of the tracheostomy performer, health-care worker safety, resource availability, and patient-centred care. We believe our modified strategic approach of brief bronchoscopy, minimum PEEP and gas flows and step-wise planned approach for PCDT offers an extra level of safety to healthcare workers. doi: https://doi.org/10.12669/pjms.36.7.3518 How to cite this:Khan E, Lal S, Hashmi J, Thomas J, Malik MA. Per-cutaneous dilatation tracheostomy (PCTD) in COVID-19 patients and peri-tracheostomy care: A case series and guidelines. Pak J Med Sci. 2020;36(7):1714-1718. doi: https://doi.org/10.12669/pjms.36.7.3518 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Databáze: | OpenAIRE |
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