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2020 ; 75
(12
): 1659-1670
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Multidisciplinary guidance for safe tracheostomy care during the COVID-19
pandemic: the NHS National Patient Safety Improvement Programme (NatPatSIP)
#MMPMID32396986
McGrath BA
; Ashby N
; Birchall M
; Dean P
; Doherty C
; Ferguson K
; Gimblett J
; Grocott M
; Jacob T
; Kerawala C
; Macnaughton P
; Magennis P
; Moonesinghe R
; Twose P
; Wallace S
; Higgs A
Anaesthesia
2020[Dec]; 75
(12
): 1659-1670
PMID32396986
show ga
The COVID-19 pandemic is causing a significant increase in the number of patients
requiring relatively prolonged invasive mechanical ventilation and an associated
surge in patients who need a tracheostomy to facilitate weaning from respiratory
support. In parallel, there has been a global increase in guidance from
professional bodies representing staff who care for patients with tracheostomies
at different points in their acute hospital journey, rehabilitation and recovery.
Of concern are the risks to healthcare staff of infection arising from
tracheostomy insertion and caring for patients with a tracheostomy. Hospitals are
also facing extraordinary demands on critical care services such that many
patients who require a tracheostomy will be managed outside established intensive
care or head and neck units and cared for by staff with little tracheostomy
experience. These concerns led NHS England and NHS Improvement to expedite the
National Patient Safety Improvement Programme's 'Safe Tracheostomy Care'
workstream as part of the NHS COVID-19 response. Supporting this workstream, UK
stakeholder organisations involved in tracheostomy care were invited to develop
consensus guidance based on: expert opinion; the best available published
literature; and existing multidisciplinary guidelines. Topics with direct
relevance for frontline staff were identified. This consensus guidance includes:
infectivity of patients with respect to tracheostomy indications and timing;
aerosol-generating procedures and risks to staff; insertion procedures; and
management following tracheostomy.