Elsevier

Oral Oncology

Volume 106, July 2020, 104767
Oral Oncology

Letter to the editor
Surgical tracheostomies in COVID-19 patients: A multidisciplinary approach and lessons learned

https://doi.org/10.1016/j.oraloncology.2020.104767Get rights and content

Highlights

  • Surgical tracheostomies have a role in the management of COVID-19 patients.

  • MDT guided and protocol-driven tracheostomy procedures are safe and effective.

  • “CORONA-steps” and “5Ts” tracheostomy protocols have shown safety and efficacy in COVID-19 patients.

  • COVID-19 transmission risk is minimised with the use of appropriate PPE and adherence to the protocol.

  • Case selection helps in ensuring good patients’ outcomes.

Abstract

Surgical tracheostomies have a role in the weaning process of COVID-19 patients treated in intensive care units. A multidisciplinary team approach (MDT) is required for decision making. This process is augmented by specific standard operating practices implemented by senior clinicians. Here, we report on our early experience and outcomes with open tracheostomies in a cohort of COVID-19 patients. We outline the criteria that guide decision making and explore the challenges faced by our intensive care colleagues in the management of these patients. The cohort was 100% male with 90% of them having a raised Body Mass Index (BMI) and other comorbidities (hypertension and diabetes). 60% have been decannulated and have been stepped down the intensive care unit. We recorded no surgical complications or adverse events. The service to date has been shown to be effective, safe, largely reproducible and reflective.

Keywords

COVID-19
CORONA
5Ts
SARS
Tracheostomy
Intensive care
Maxillofacial
MDT

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