Recommendations for Tracheotomy During SARS-CoV-2Pandemic
As the number of infected patients requiring intubation and ventilator support climbs, a growing population of patients would normally qualify for tracheotomy due to failed extubation or prolonged ventilatory needs. Considering the clear evidence from both SARS and SARS-CoV-2 infection9, it is imperative that this patient population be managed appropriately to minimize infectious risk to the healthcare team.
Currently, there are no published reports on tracheotomy in patients with COVID-19. We felt there were numerous reasons to develop consensus guidelines including:
emotionally charged issue.
To address these concerns, we assembled a task force of stakeholders in our medical center involved with tracheotomy including otolaryngology, trauma surgery, critical care medicine and anesthesiology. The group reviewed existing literature and met virtually to draft recommendations. Ideas were refined with final recommendations approved by all Task Force members as summarized below. The availability of highly predictive testing for SARS- CoV-2 has greatly simplified the decision process in our medical center; improving the safety of medical staff, preserving resources like PPE and freeing up resources like ventilators and ICU space.