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

Abstract 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 f...

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Main Authors: D. D. Sommer, P. T. Engels, E.K. Weitzel, S. Khalili, M. Corsten, M. A. Tewfik, K. Fung, D. Cote, M. Gupta, N. Sne, T. F. E. Brown, J. Paul, K. M. Kost, I. J. Witterick
Format: Article
Language:English
Published: SAGE Publishing 2020-04-01
Series:Journal of Otolaryngology - Head and Neck Surgery
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Online Access:http://link.springer.com/article/10.1186/s40463-020-00414-9
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author D. D. Sommer
P. T. Engels
E.K. Weitzel
S. Khalili
M. Corsten
M. A. Tewfik
K. Fung
D. Cote
M. Gupta
N. Sne
T. F. E. Brown
J. Paul
K. M. Kost
I. J. Witterick
author_facet D. D. Sommer
P. T. Engels
E.K. Weitzel
S. Khalili
M. Corsten
M. A. Tewfik
K. Fung
D. Cote
M. Gupta
N. Sne
T. F. E. Brown
J. Paul
K. M. Kost
I. J. Witterick
author_sort D. D. Sommer
collection DOAJ
description Abstract 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.
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spelling doaj-art-5b85192fd6144936851bb064df5c4be22025-08-20T01:47:50ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162020-04-014911410.1186/s40463-020-00414-9Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemicD. D. Sommer0P. T. Engels1E.K. Weitzel2S. Khalili3M. Corsten4M. A. Tewfik5K. Fung6D. Cote7M. Gupta8N. Sne9T. F. E. Brown10J. Paul11K. M. Kost12I. J. Witterick13Division of Otolaryngology - Head & Neck Surgery - Department of Surgery, McMaster University Medical Centre, McMaster UniversityDepartment of Surgery and Critical Care, McMaster UniversityUnited States Army Institute of Surgical ResearchAurora Neuroscience Innovation InstituteDivision of Otolaryngology - Head & Neck Surgery, Dalhousie UniversityDepartment of Otolaryngology - Head and Neck Surgery, McGill UniversityDepartment of Otolaryngology - Head and Neck Surgery, Western UniversityDivision of Otolaryngology - Head and Neck Surgery, University of AlbertaDivision of Otolaryngology - Head & Neck Surgery - Department of Surgery, McMaster University Medical Centre, McMaster UniversityDepartment of Surgery and Critical Care, McMaster UniversityDivision of Otolaryngology - Head & Neck Surgery, Dalhousie UniversityDepartment of Anesthesia, McMaster UniversityDepartment of Otolaryngology - Head and Neck Surgery, McGill UniversityDepartment of Otolaryngology - Head & Neck Surgery, University of TorontoAbstract 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.http://link.springer.com/article/10.1186/s40463-020-00414-9TracheotomyTracheostomyCovid-19CoronavirusSARS-CoV-2Airway
spellingShingle D. D. Sommer
P. T. Engels
E.K. Weitzel
S. Khalili
M. Corsten
M. A. Tewfik
K. Fung
D. Cote
M. Gupta
N. Sne
T. F. E. Brown
J. Paul
K. M. Kost
I. J. Witterick
Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic
Journal of Otolaryngology - Head and Neck Surgery
Tracheotomy
Tracheostomy
Covid-19
Coronavirus
SARS-CoV-2
Airway
title Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic
title_full Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic
title_fullStr Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic
title_full_unstemmed Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic
title_short Recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic
title_sort recommendations from the cso hns taskforce on performance of tracheotomy during the covid 19 pandemic
topic Tracheotomy
Tracheostomy
Covid-19
Coronavirus
SARS-CoV-2
Airway
url http://link.springer.com/article/10.1186/s40463-020-00414-9
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