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European Archives of Oto-Rhino-Laryngology

Published in:

01-02-2021 | Care | Review Article

Tracheostomy care and decannulation during the COVID-19 pandemic. A multidisciplinary clinical practice guideline

Authors: Aleix Rovira, Deborah Dawson, Abigail Walker, Chrysostomos Tornari, Alison Dinham, Neil Foden, Pavol Surda, Sally Archer, Dagan Lonsdale, Jonathan Ball, Enyi Ofo, Yakubu Karagama, Tunde Odutoye, Sarah Little, Ricard Simo, Asit Arora

Published in: European Archives of Oto-Rhino-Laryngology | Issue 2/2021

Abstract

Purpose

Traditional critical care dogma regarding the benefits of early tracheostomy during invasive ventilation has had to be revisited due to the risk of COVID-19 to patients and healthcare staff. Standard practises that have evolved to minimise the risks associated with tracheostomy must be comprehensively reviewed in light of the numerous potential episodes for aerosol generating procedures. We meet the urgent need for safe practise standards by presenting the experience of two major London teaching hospitals, and synthesise our findings into an evidence-based guideline for multidisciplinary care of the tracheostomy patient.

Methods

This is a narrative review presenting the extensive experience of over 120 patients with tracheostomy, with a pragmatic analysis of currently available evidence for safe tracheostomy care in COVID-19 patients.

Results

Tracheostomy care involves many potentially aerosol generating procedures which may pose a risk of viral transmission to staff and patients. We make a series of recommendations to ameliorate this risk through infection control strategies, equipment modification, and individualised decannulation protocols. In addition, we discuss the multidisciplinary collaboration that is absolutely fundamental to safe and effective practise.

Conclusion

COVID-19 requires a radical rethink of many tenets of tracheostomy care, and controversy continues to exist regarding the optimal techniques to minimise risk to patients and healthcare workers. Safe practise requires a coordinated multidisciplinary team approach to infection control, weaning and decannulation, with integrated processes for continuous prospective data collection and audit.

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Title: Tracheostomy care and decannulation during the COVID-19 pandemic. A multidisciplinary clinical practice guideline
Authors: Aleix Rovira
Deborah Dawson
Abigail Walker
Chrysostomos Tornari
Alison Dinham
Neil Foden
Pavol Surda
Sally Archer
Dagan Lonsdale
Jonathan Ball
Enyi Ofo
Yakubu Karagama
Tunde Odutoye
Sarah Little
Ricard Simo
Asit Arora
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: Care
COVID-19
Tracheostomy
Published in: European Archives of Oto-Rhino-Laryngology / Issue 2/2021
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06126-0

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Tracheostomy care and decannulation during the COVID-19 pandemic. A multidisciplinary clinical practice guideline

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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