The coronavirus SARS-CoV-2 (COVID-19) pandemic has offered a unique set of challenges to the medical community often requiring prolonged treatment algorithms. The illness, afflicting more than 7.3 million people worldwide with estimates of 5-20% requiring critical care, has become a burden on the healthcare community. These critically ill patients who acquire the severe form of the disease routinely require prolonged invasive mechanical ventilation. The questions then arise, “when and for whom does tracheostomy become indicated,” and “how to safely perform a tracheostomy in this patient population.” With consideration to aerosolization of the virus, we have derived and instituted a protocol at a community institution with aims of reducing provider risk while safely performing a tracheostomy. An open tracheostomy was performed at bedside, within a negative pressure intensive care unit (ICU) setting, utilizing a closed-circuit technique as described in this text. A total of 17 tracheostomies were performed employing the described technique. Minimal complications were noted throughout the study and no adverse oxygenation events were observed with an average total apneic time of 106 seconds. An acceptable mortality rate of 23% was observed given the lethal nature of this disease in ventilated, critically ill patients. No nosocomial transmission of the virus was documented for all team members. This protocol can be used to determine efficacy and safely execute a tracheostomy in COVID-19 patients. As information about COVID-19 continues to unfold, protocols for high risk procedures will need to fluidly evolve.
Published in | International Journal of Cardiovascular and Thoracic Surgery (Volume 6, Issue 3) |
DOI | 10.11648/j.ijcts.20200603.11 |
Page(s) | 38-43 |
Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
COVID-19, Tracheostomy, Protocol, Indication
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APA Style
Brian Temple, Michael Segal, Vijay A Singh, Daniel Galvin, Robert Kerr, et al. (2020). Implementation of a Tracheostomy Protocol During the COVID-19 Pandemic. International Journal of Cardiovascular and Thoracic Surgery, 6(3), 38-43. https://doi.org/10.11648/j.ijcts.20200603.11
ACS Style
Brian Temple; Michael Segal; Vijay A Singh; Daniel Galvin; Robert Kerr, et al. Implementation of a Tracheostomy Protocol During the COVID-19 Pandemic. Int. J. Cardiovasc. Thorac. Surg. 2020, 6(3), 38-43. doi: 10.11648/j.ijcts.20200603.11
AMA Style
Brian Temple, Michael Segal, Vijay A Singh, Daniel Galvin, Robert Kerr, et al. Implementation of a Tracheostomy Protocol During the COVID-19 Pandemic. Int J Cardiovasc Thorac Surg. 2020;6(3):38-43. doi: 10.11648/j.ijcts.20200603.11
@article{10.11648/j.ijcts.20200603.11, author = {Brian Temple and Michael Segal and Vijay A Singh and Daniel Galvin and Robert Kerr and Robert Zingale}, title = {Implementation of a Tracheostomy Protocol During the COVID-19 Pandemic}, journal = {International Journal of Cardiovascular and Thoracic Surgery}, volume = {6}, number = {3}, pages = {38-43}, doi = {10.11648/j.ijcts.20200603.11}, url = {https://doi.org/10.11648/j.ijcts.20200603.11}, eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20200603.11}, abstract = {The coronavirus SARS-CoV-2 (COVID-19) pandemic has offered a unique set of challenges to the medical community often requiring prolonged treatment algorithms. The illness, afflicting more than 7.3 million people worldwide with estimates of 5-20% requiring critical care, has become a burden on the healthcare community. These critically ill patients who acquire the severe form of the disease routinely require prolonged invasive mechanical ventilation. The questions then arise, “when and for whom does tracheostomy become indicated,” and “how to safely perform a tracheostomy in this patient population.” With consideration to aerosolization of the virus, we have derived and instituted a protocol at a community institution with aims of reducing provider risk while safely performing a tracheostomy. An open tracheostomy was performed at bedside, within a negative pressure intensive care unit (ICU) setting, utilizing a closed-circuit technique as described in this text. A total of 17 tracheostomies were performed employing the described technique. Minimal complications were noted throughout the study and no adverse oxygenation events were observed with an average total apneic time of 106 seconds. An acceptable mortality rate of 23% was observed given the lethal nature of this disease in ventilated, critically ill patients. No nosocomial transmission of the virus was documented for all team members. This protocol can be used to determine efficacy and safely execute a tracheostomy in COVID-19 patients. As information about COVID-19 continues to unfold, protocols for high risk procedures will need to fluidly evolve.}, year = {2020} }
TY - JOUR T1 - Implementation of a Tracheostomy Protocol During the COVID-19 Pandemic AU - Brian Temple AU - Michael Segal AU - Vijay A Singh AU - Daniel Galvin AU - Robert Kerr AU - Robert Zingale Y1 - 2020/07/17 PY - 2020 N1 - https://doi.org/10.11648/j.ijcts.20200603.11 DO - 10.11648/j.ijcts.20200603.11 T2 - International Journal of Cardiovascular and Thoracic Surgery JF - International Journal of Cardiovascular and Thoracic Surgery JO - International Journal of Cardiovascular and Thoracic Surgery SP - 38 EP - 43 PB - Science Publishing Group SN - 2575-4882 UR - https://doi.org/10.11648/j.ijcts.20200603.11 AB - The coronavirus SARS-CoV-2 (COVID-19) pandemic has offered a unique set of challenges to the medical community often requiring prolonged treatment algorithms. The illness, afflicting more than 7.3 million people worldwide with estimates of 5-20% requiring critical care, has become a burden on the healthcare community. These critically ill patients who acquire the severe form of the disease routinely require prolonged invasive mechanical ventilation. The questions then arise, “when and for whom does tracheostomy become indicated,” and “how to safely perform a tracheostomy in this patient population.” With consideration to aerosolization of the virus, we have derived and instituted a protocol at a community institution with aims of reducing provider risk while safely performing a tracheostomy. An open tracheostomy was performed at bedside, within a negative pressure intensive care unit (ICU) setting, utilizing a closed-circuit technique as described in this text. A total of 17 tracheostomies were performed employing the described technique. Minimal complications were noted throughout the study and no adverse oxygenation events were observed with an average total apneic time of 106 seconds. An acceptable mortality rate of 23% was observed given the lethal nature of this disease in ventilated, critically ill patients. No nosocomial transmission of the virus was documented for all team members. This protocol can be used to determine efficacy and safely execute a tracheostomy in COVID-19 patients. As information about COVID-19 continues to unfold, protocols for high risk procedures will need to fluidly evolve. VL - 6 IS - 3 ER -