CORONA-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management

Piccin, Ottavio; D'Alessio, Pasquale; Mattucci, Giulia; Santi, Gabriella De; Abeshi, Andi

doi:10.1016/j.oraloncology.2020.104796

Cited by 3 publications

(1 citation statement)

References 2 publications

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“…The sequelae of prolonged endotracheal intubation are well known and recognized. Performing a tracheotomy may improve patients' comfort, lower frequency of oral lesions, clear airway secretions, reduce the dose and duration of analgesia and sedative drugs, avoid complications related to prolonged analgesia and sedation, reduce dead-space ventilation and airway resistive load, improve expiratory flow, expedite rehabilitation and allow for easier, safer and faster weaning from ventilator (17,(33)(34)(35)(36)(37). In clinical practice, the decision to perform tracheotomy should be based on the balance between exact expected benefits and optimal care of the selected patients and the possible risk of SARS-CoV-2 transmission to operators.…”

Section: Discussionmentioning

confidence: 99%

A safer and more practical tracheotomy in invasive mechanical ventilated patients with COVID-19: A quality improvement study

Kang

Wang²,

Du³

et al. 2022

Front. Surg.

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ImportanceThe number of infections and deaths caused by the global epidemic of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) invasion is steadily increasing daily. In the early stages of outbreak, approximately 15%–20% of patients with coronavirus disease 2019 (COVID-19) inevitably developed severe and critically ill forms of the disease, especially elderly patients and those with several or serious comorbidities. These more severe forms of disease mainly manifest as dyspnea, reduced blood oxygen saturation, severe pneumonia, acute respiratory distress syndrome (ARDS), thus requiring prolonged advanced respiratory support, including high-flow nasal cannula (HFNC), non-invasive mechanical ventilation (NIMV), and invasive mechanical ventilation (IMV).ObjectiveThis study aimed to propose a safer and more practical tracheotomy in invasive mechanical ventilated patients with COVID-19.DesignThis is a single center quality improvement study.ParticipantsTracheotomy is a necessary and important step in airway management for COVID-19 patients with prolonged endotracheal intubation, IMV, failed extubation, and ventilator dependence. Standardized third-level protection measures and bulky personal protective equipment (PPE) may hugely impede the implementation of tracheotomy, especially when determining the optimal pre-surgical positioning for COVID-19 patients with ambiguous surface position, obesity, short neck or limited neck extension, due to vision impairment, reduced tactile sensation and motility associated with PPE. Consequently, the aim of this study was to propose a safer and more practical tracheotomy, namely percutaneous dilated tracheotomy (PDT) with delayed endotracheal intubation withdrawal under the guidance of bedside ultrasonography without the conventional use of flexible fiberoptic bronchoscopy (FFB), which can accurately determine the optimal pre-surgical positioning, as well as avoid intraoperative damage of the posterior tracheal wall and prevent the occurrence of tracheoesophageal fistula (TEF).

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Section: Discussionmentioning

confidence: 99%

A safer and more practical tracheotomy in invasive mechanical ventilated patients with COVID-19: A quality improvement study

Kang

Wang²,

Du³

et al. 2022

Front. Surg.

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CORONA-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management

et al. 2020

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Introducing the FATLIPS acronym for assessing the red flag clinical features of dental infection

et al. 2021

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Introduction Dental infection can progress to life-threatening cervicofacial and deep space infections. Therefore, safe management requires early identification of serious infections in primary care with appropriate referral to secondary care. We have developed an acronym to aid assessment of the red flag clinical features for serious dental infection in primary care by general dental practitioners. Materials and methods Literature review and focus group discussions. Results We introduce the FATLIPS acronym for assessment of red flag features of dental infection: failed previous treatment(s), airway compromise, trismus, look (lower border mandible, orbit, oral, neck), immunosuppression, pyrexia, swallowing difficulties. Conclusion We propose the FATLIPS red flags acronym to help dentists assess the red flag features of dental infections in primary care.

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CORONA-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management

Cited by 3 publications

References 2 publications

A safer and more practical tracheotomy in invasive mechanical ventilated patients with COVID-19: A quality improvement study

A safer and more practical tracheotomy in invasive mechanical ventilated patients with COVID-19: A quality improvement study

CORONA-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management

Introducing the FATLIPS acronym for assessing the red flag clinical features of dental infection

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