Preoperative Fear, Operative Gear, and Postoperative Care, in Tracheostomy during Covid Times – Our Experience at a Tertiary Care Hospital

Abstract

BACKGROUND The SARS-CoV-2 is known to be highly contagious from respiratory tract droplets and aerosol exposure. ENT surgeons deal with the upper airway and are exposed to aerosol generating procedures on a daily basis. Aerosol generating procedure such as tracheostomy is necessary in patients with head and neck cancers having airway obstruction. METHODS We share our experience of 38 cases where we had to perform tracheostomy during these Covid times under various circumstances in a tertiary care centre with a dedicated Covid Isolation centre for 5 districts with 210 beds reserved for Covid patients. RESULTS All 38 tracheostomies were performed successfully following the guidelines formulated by our team, with proper precautions not a single team member got infected with Covid-19. No test is 100 % sensitive, so all precautions must be taken while dealing with every patient and PPEs should be used in all tracheostomies. CONCLUSIONS No test is 100 % sensitive, so all precautions must be taken while dealing with every patient and PPEs should be used in all tracheostomies. Our policy of anticipating tracheostomy in patients with impending stridor helped us reduce the risk of having to perform emergency tracheostomies with Covid status unknown. KEY WORDS Aerosol, COVID-19, PPE - Kit, SARS-CoV-2, Stridor, Tracheostomy