Bedside open tracheostomy in COVID-19 patients - a safe and swift approach.
Wahid, N-W Deutsch, P Amlani, A Gupta, K-K Griffiths, H Ahmad, I
Wahid, N-W
Deutsch, P
Amlani, A
Gupta, K-K
Griffiths, H
Ahmad, I
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2023-11-22
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Abstract
Background: Tracheostomy can be performed as an open surgical procedure, percutaneous, or hybrid and forms an important step in the management of patients infected with coronavirus disease 2019 (COVID-19) requiring weaning from mechanical ventilation. The purpose of this article is to share our experience to performing bedside surgical tracheostomy in COVID-19 patients in a safe and effective manner, whilst minimising the risk of viral transmission, to optimise patient outcomes and reduce risk to healthcare professionals.
Material and methods: As recommended by ENT UK, we prospectively established a COVID Airway Team within the ENT department at Birmingham Heartlands Hospital, consisting of four head and neck consultant surgeons to perform either open-bedside, open-theatre or percutaneous tracheostomy in COVID-19 patients. A specific stepwise method for bedside open surgical tracheostomy was based on ENT UK and British Laryngological Society recommendations.
Results: Thirty patients underwent tracheostomy during the study period (14 bedside-open, 5 open-theatre, 11 percutaneous). Mean duration of mechanical intubation prior to bedside-open tracheostomy was 14.5 days. The average time for open-bedside tracheostomy was 9 minutes compared to 31 minutes for open-theatre. There were no significant tracheostomy related complications with bedside-open tracheostomy. No healthcare professional involved reported acute COVID-19 infection.
Conclusions: We describe our effective, safe and swift approach to bedside open tracheostomy during the COVID-19 pandemic. Our experience demonstrated a short mean procedural time, with no tracheostomy-related complications and no reported viral transmission amongst the healthcare members involved.
Citation
Wahid NW, Deutsch P, Amlani A, Gupta KK, Griffiths H, Ahmad I. Bedside open tracheostomy in COVID-19 patients - a safe and swift approach. Med Oral Patol Oral Cir Bucal. 2023 Nov 22:26326. doi: 10.4317/medoral.26326. Epub ahead of print. PMID: 37992143.
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