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Emergency management plan for paediatric patients with tracheostomies during the coronavirus disease 2019 pandemic

Published online by Cambridge University Press:  05 July 2022

B Petulla ,
E Ho Open the ORCID record for E Ho [Opens in a new window] ,
E Sov  and
M Soma
B Petulla
Affiliation:
Department of Otolaryngology, Sydney Children's Hospital, Randwick, Australia
E Ho*
Affiliation:
Department of Otolaryngology, Sydney Children's Hospital, Randwick, Australia
E Sov
Affiliation:
Department of Otolaryngology, Sydney Children's Hospital, Randwick, Australia
M Soma
Affiliation:
Department of Otolaryngology, Sydney Children's Hospital, Randwick, Australia School of Women and Children's Health, University of New South Wales Sydney, Australia
*
Author for correspondence: Dr Emma Ho, Department of Otolaryngology, Sydney Children's Hospital, Randwick, Australia E-mail: [email protected]
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Abstract

Objectives

Paediatric patients with tracheostomies are a vulnerable group. During the coronavirus disease 2019 pandemic, healthcare workers can be anxious about viral transmission from secretions and aerosols emerging from the open airway. This paper aims to share a systematic approach to decrease staff exposure and optimise care of these patients.

Methods

Three documents were developed: a generic tracheostomy management plan detailing troubleshooting; a personalised management plan with customised recommendations; and a guide for tracheostomy tube change to minimise aerosol production.

Results

The plan was distributed to 31 patients (age range, 11 months to 17 years) including 23 (74.2 per cent) with uncuffed tubes and 9 (29 per cent) on long-term ventilation. There have been 10 occasions in which the plan was utilised and influenced management.

Conclusion

A structured approach to emergency presentations during the coronavirus disease 2019 pandemic may safeguard paediatric patients from unnecessary manipulation of their tracheostomy tube, minimise viral exposure and allow provision of expeditious care.

Keywords

COVID-19PediatricsTracheostomyRisk ManagementQuality Improvement
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 12 , December 2022 , pp. 1289 - 1295
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr E Ho takes responsibility for the integrity of the content of the paper

References

Adil, MT, Rahman, R, Whitelaw, D, Jain, V, Al-Taan, O, Rashid, F et al. SARS-CoV-2 and the pandemic of COVID-19. Postgrad Med J 2021;97:110–16CrossRefGoogle ScholarPubMed
Wiersinga, WJ, Rhodes, A, Cheng, AC, Peacock, SJ, Prescott, HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA 2020;324:782–93CrossRefGoogle ScholarPubMed
Mick, P, Murphy, R. Aerosol-generating otolaryngology procedures and the need for enhanced PPE during the COVID-19 pandemic: a literature review. J Otolaryngol Head Neck Surg 2020;49:29CrossRefGoogle ScholarPubMed
Workman, AD, Welling, DB, Carter, BS, Curry, WT, Holbrook, EH, Gray, ST et al. Endonasal instrumentation and aerosolization risk in the era of COVID-19: simulation, literature review, and proposed mitigation strategies. Int Forum Allergy Rhinol 2020;10:798–805CrossRefGoogle ScholarPubMed
Lockhart, SL, Duggan, LV, Wax, RS, Saad, S, Grocott, HP. Personal protective equipment (PPE) for both anesthesiologists and other airway managers: principles and practice during the COVID-19 pandemic. Can J Anaesth 2020;67:1005–15CrossRefGoogle ScholarPubMed
Thamboo, A, Lea, J, Sommer, DD, Sowerby, L, Abdalkhani, A, Diamond, C et al. Clinical evidence based review and recommendations of aerosol generating medical procedures in otolaryngology - head and neck surgery during the COVID-19 pandemic. J Otolaryngol Head Neck Surg 2020;49:28CrossRefGoogle ScholarPubMed
Kana, LA, Shuman, AG, Helman, J, Krawcke, K, Brown, DJ. Disparities and ethical considerations for children with tracheostomies during the COVID-19 pandemic. J Pediatr Rehabil Med 2020;13:371–6CrossRefGoogle ScholarPubMed
Praud, JP. Long-term non-invasive ventilation in children: current use, indications, and contraindications. Front Pediatr 2020;8:584334CrossRefGoogle ScholarPubMed
Sydney Children's Hospital Network. COVID-19 Standard Operating Procedure, Emergency Tracheostomy – Non-Ventilated Patient (No: S 94 v1). Sydney: Sydney Children's Hospital, 2020Google Scholar
Smith, JD, Chen, MM, Balakrishnan, K, Sidell, DR, di Stadio, A, Schechtman, SA et al. The difficult airway and aerosol-generating procedures in COVID-19: timeless principles for uncertain times. Otolaryngol Head Neck Surg 2020;163:934–7CrossRefGoogle ScholarPubMed
McGrath, BA, Ashby, N, Birchall, M, Dean, P, Doherty, C, Ferguson, K et al. Multidisciplinary guidance for safe tracheostomy care during the COVID-19 pandemic: the NHS National Patient Safety Improvement Programme (NatPatSIP). Anaesthesia 2020;75:1659–70CrossRefGoogle ScholarPubMed
Pande, RK, Bhalla, A, Myatra, SN, Yaddanpuddi, LN, Gupta, S, Sahoo, TK et al. Procedures in COVID-19 patients: part-I. Indian J Crit Care Med 2020;24:S263–71Google ScholarPubMed
Gün, E, Botan, E, Özdemir, H, Kendirli, T. Successful treatment of COVID-19 infection in a child with tracheostomy. Tuberk Toraks 2021;69:285–7CrossRefGoogle Scholar
Gray, DM, Davies, MA, Githinji, L, Levin, M, Mapani, M, Nowalaza, Z et al. COVID-19 and pediatric lung disease: a South African tertiary center experience. Front Pediatr 2021;8:614076CrossRefGoogle ScholarPubMed
Ahmed, ST, Yang, C, Deng, J, Bottalico, DM, Matta-Arroyo, E, Cassel-Choudhury, G et al. Implementation of an online multimedia pediatric tracheostomy care module for healthcare providers. Laryngoscope 2021;131:1893–901CrossRefGoogle ScholarPubMed