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Per-cutaneous dilatation tracheostomy (PCTD) in COVID-19 patients and peri-tracheostomy care: a case series and guidelines

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posted on 15.03.2022, 16:35 by Ehtesham KhanEhtesham Khan, Shankar Lal, Junaid Hashmi, Jubil Thomas, Muhammad Anwar Malik
Background & Objective: 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 wish to highlight our modified technique to address these issues.
Methods: We performed percutaneous dilation tracheostomy in three clinically challenging COVID-19 patients in our ICU and developed guidelines aiming to minimise aerosolisation during and after the tracheostomy procedure to safeguard healthcare workers.
Results: Percutaneous tracheostomy was performed by a team of three experienced anaesthetists and an ICU nurse.
Conclusion: 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 of brief bronchoscopy, minimum PEEP and gas flows and step-wise planned approach for PCDT offers an extra level of safety to healthcare workers.

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The original article is available at http://pjms.org.pk/

Published Citation

Khan E, Lal S, Hashmi J, Thomas J, Malik MA. Per-cutaneous dilatation tracheostomy (PCTD) in COVID-19 patients and peri-tracheostomy care: a case series and guidelines. Pak J Med Sci. 2020;36(7):1714-1718.

Publication Date

19 October 2020

PubMed ID

33235603

Publisher

Professional Medical Publications

Version

  • Published Version (Version of Record)