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10.1177/0194599820961990

http://scihub22266oqcxt.onion/10.1177/0194599820961990
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32960148!8198753!32960148
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suck abstract from ncbi


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pmid32960148      Otolaryngol+Head+Neck+Surg 2021 ; 164 (5): 984-1000
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  • Multidisciplinary Safety Recommendations After Tracheostomy During COVID-19 Pandemic: State of the Art Review #MMPMID32960148
  • Meister KD; Pandian V; Hillel AT; Walsh BK; Brodsky MB; Balakrishnan K; Best SR; Chinn SB; Cramer JD; Graboyes EM; McGrath BA; Rassekh CH; Bedwell JR; Brenner MJ
  • Otolaryngol Head Neck Surg 2021[May]; 164 (5): 984-1000 PMID32960148show ga
  • OBJECTIVE: In the chronic phase of the COVID-19 pandemic, questions have arisen regarding the care of patients with a tracheostomy and downstream management. This review addresses gaps in the literature regarding posttracheostomy care, emphasizing safety of multidisciplinary teams, coordinating complex care needs, and identifying and managing late complications of prolonged intubation and tracheostomy. DATA SOURCES: PubMed, Cochrane Library, Scopus, Google Scholar, institutional guidance documents. REVIEW METHODS: Literature through June 2020 on the care of patients with a tracheostomy was reviewed, including consensus statements, clinical practice guidelines, institutional guidance, and scientific literature on COVID-19 and SARS-CoV-2 virology and immunology. Where data were lacking, expert opinions were aggregated and adjudicated to arrive at consensus recommendations. CONCLUSIONS: Best practices in caring for patients after a tracheostomy during the COVID-19 pandemic are multifaceted, encompassing precautions during aerosol-generating procedures; minimizing exposure risks to health care workers, caregivers, and patients; ensuring safe, timely tracheostomy care; and identifying and managing laryngotracheal injury, such as vocal fold injury, posterior glottic stenosis, and subglottic stenosis that may affect speech, swallowing, and airway protection. We present recommended approaches to tracheostomy care, outlining modifications to conventional algorithms, raising vigilance for heightened risks of bleeding or other complications, and offering recommendations for personal protective equipment, equipment, care protocols, and personnel. IMPLICATIONS FOR PRACTICE: Treatment of patients with a tracheostomy in the COVID-19 pandemic requires foresight and may rival procedural considerations in tracheostomy in their complexity. By considering patient-specific factors, mitigating transmission risks, optimizing the clinical environment, and detecting late manifestations of severe COVID-19, clinicians can ensure due vigilance and quality care.
  • |*Postoperative Care[MESH]
  • |*Tracheostomy[MESH]
  • |COVID-19/*prevention & control[MESH]
  • |Cross Infection/prevention & control[MESH]
  • |Humans[MESH]
  • |Infection Control/*standards[MESH]
  • |Infectious Disease Transmission, Patient-to-Professional/prevention & control[MESH]
  • |Pandemics[MESH]
  • |Personal Protective Equipment[MESH]
  • |Postoperative Complications/prevention & control[MESH]


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