Use of Tracheostomy in COVID-19 Patients and it’s Effects on Healthcare Workers

Abstract

Tracheostomy in COVID-19 patients needs important decision making and surgical planning, especially since it’s an aerosol-generating procedure and poses a threat to the health care personnel involved. Various public health agencies have recognized that some particular health care procedures considerably increase the risk of transmission of respiratory pathogens because they produce aerosols. Severe infection with SARS-CoV-2 [COVID-19] causes respiratory illness resulting in Acute Respiratory Distress Syndrome (ARDS) and respiratory failure that put patients in need of intrusive mechanical ventilation. Because it is linked to longer use of sedatives, narcotics, muscle palsy leading to a longing desire for invasive central catheters, and the patient's stationary position inflicting line infection and pressure injuries to the skin, prolonged invasive mechanical ventilation usually results in ventilator-associated pneumonia and other complications. If patients are projected to be ventilator-dependent for a lengthy period of time, surgical treatment is considered once every 7–10 days for automatically ventilated patients. However, due to the risk faced by the health care workers, it has been recommended by organizations such as WHO, that health personnel must take appropriate measures so as to minimize the risk of contracting the deadly virus. This includes wearing personal protective equipment [PPE] while performing the procedure. An N-95[or above] face mask, face shield, latex gloves, full-body disposable cover, foot covers are some of the contents of personal protective equipment [PPE]. Our goal is to provide authoritative guidance to healthcare providers and healthcare systems and to highlight the possible effects of the accumulating experiences, currently available evidence, and historical lessons, tracheostomy decisions during the current COVID19 epidemic. Because incubated patients have a poor prognosis and there is a danger of transfer to providers through this highly aerosolizing procedure, the pathway of tracheostomy placement has changed.