Consensus français sur la réalisation de trachéotomies et les soins de
trachéotomies pendant la pandémie de COVID-19
#MMPMIDC7166014
Schultz P
; Morvan JB
; Fakhry N
; Morinière S
; Vergez S
; Lacroix C
; Bartier S
; Barry B
; Babin E
; Couloigner V
; Atallah I
?-/-? 2020[Apr]; ? (?): ? PMIDC7166014
show ga
Tracheostomy post-tracheostomy care are regarded as at high risk for
contamination of health care professionals with the new coronavirus (SARS-CoV-2).
Considering the rapid spread of the infection, all patients in France must be
considered as potentially infected by the virus. Nevertheless, patients without
clinical or radiological (CT scan) markers of COVID-19, and with negative
nasopharyngeal sample within 24h of surgery, are at low risk of being infected.
Instructions for personal protection include specific wound dressings and
decontamination of all material used. The operating room should be ventilated
after each tracheostomy and the pressure of the room should be neutral or
negative. Percutaneous tracheostomy is to be preferred over surgical cervicotomy
in order to reduce aerosolization and to avoid moving patients from the intensive
care unit to the operating room. Ventilation must be optimized during the
procedure, to limit patient oxygen desaturation. Drug assisted neuromuscular
blockage is advised to reduce coughing during tracheostomy tube insertion. An
experienced team is mandatory to secure and accelerate the procedure as well as
to reduce risk of contamination.
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