Healthcare Personnel Safety During Percutaneous Tracheostomy in Patients With COVID-19: Proof-of-Concept Study
Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine; Department of Internal Medicine; Department of Surgery, Division of Thoracic Surgery
Critical Care | Health Services Administration | Infectious Disease | Surgery | Surgical Procedures, Operative | Virus Diseases
BACKGROUND: Covid-19 pandemic has resulted in the development of severe and persistent respiratory failure requiring long term ventilatory support. This necessitates the need for a reliable and easy to implement tracheostomy protocol given the concern for viral transmission risk to the involved healthcare personnel due to the aerosol generating nature of the procedure. We describe a protocol with unique and novel modifications to the Ciaglia dilatational percutaneous tracheostomy, effectively implemented during the Covid-19 pandemic at our institution.
METHODS: We describe the baseline characteristics of our initial 11 patients who underwent the procedure. Outlined are the healthcare personnel involved and the steps which are organized into 4 phases: planning, pre-procedure, intra-procedure and post-procedure. We have tracked procedural duration, provider safety as well as the development of new complications.
RESULTS: We describe use of this protocol for 11 bedside percutaneous tracheostomies performed on patients with COVID-19. The average total procedural duration as well as incision to tracheostomy tube placement times was 32.6 minutes and 5.8 minutes respectively. All 3 providers performing the tracheostomies remained asymptomatic with negative COVID-19 RT-PCR testing at 3 weeks.
CONCLUSIONS: We report an efficacious and adaptable protocol for elective bedside percutaneous tracheostomies for patients with persistent ventilatory requirements due to COVID-19 with an intent to provide standardized and safe care for the patient and the involved healthcare personnel.
COVID-19, safety, tracheostomy tube
DOI of Published Version
Sood RN, Dudiki N, Alape D, Maxfiel MW. Healthcare Personnel Safety During Percutaneous Tracheostomy in Patients With COVID-19: Proof-of-Concept Study. J Intensive Care Med. 2020 Dec 16:885066620980384. doi: 10.1177/0885066620980384. Epub ahead of print. PMID: 33323033. Link to article on publisher's site
Journal of intensive care medicine
Sood RN, Dudiki N, Alape D, Maxfield MW. (2020). Healthcare Personnel Safety During Percutaneous Tracheostomy in Patients With COVID-19: Proof-of-Concept Study. COVID-19 Publications by UMMS Authors. https://doi.org/10.1177/0885066620980384. Retrieved from https://escholarship.umassmed.edu/covid19/159