Healthcare Personnel Safety During Percutaneous Tracheostomy in Patients With COVID-19: Proof-of-Concept Study
UMass Chan Affiliations
Department of Surgery, Division of Thoracic SurgeryDepartment of Internal Medicine
Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine
Document Type
Journal ArticlePublication Date
2020-12-16Keywords
COVID-19safety
tracheostomy tube
Critical Care
Health Services Administration
Infectious Disease
Surgery
Surgical Procedures, Operative
Virus Diseases
Metadata
Show full item recordAbstract
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.Source
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
DOI
10.1177/0885066620980384Permanent Link to this Item
http://hdl.handle.net/20.500.14038/27364PubMed ID
33323033Related Resources
ae974a485f413a2113503eed53cd6c53
10.1177/0885066620980384