Per-cutaneous dilatation tracheostomy (PCTD) in COVID-19 patients and
steps to prevent Aerosolisation: A Case Series.
• COVID 19 patients with severe respiratory failure may require
prolonged mechanical ventilation. Placement of a tracheostomy tube often
becomes necessary for such patients. • The steps of tracheostomy
procedure and post tracheostomy care of these patients can be classified
as aerosol generating. • We performed percutaneous dilation tracheostomy
in three clinically challenging COVID-19 patients in our ICU. • We
developed guidelines aiming to minimise aerosolisation during and after
the tracheostomy procedure to safeguard healthcare workers. Percutaneous
tracheostomy was performed by a team of three experienced anaesthetists
and an ICU nurse. • The decision of surgical or percutaneous
tracheostomy should be dependent on the experience of the tracheostomy
performer, health-care worker safety, resource availability, and
patient-centred care. We believe our modified strategic approach for
PCDT offers an extra level of safety to healthcare workers.