Summary Points:
- Careful consideration of “who” and “when” when
tracheostomy is planned.
- Careful consideration of the location and technique to avoid
unnecessary risks to health care providers.
- When clinically appropriate, delay of tracheostomy procedures
is recommended to allow for reduced viral load and decrease the risk
of nosocomial infection to critical health care providers.
- Careful monitoring of EET cuff pressures to maintain
appropriate seal to avoid aerosolization, while mitigating the risk of
long-term tracheal complications.
- Appropriate PPE training and utilization, including N95 or
PAPR when indicated is recommended for all patients undergoing
tracheostomy, regardless of SARS-CoV-2 status, during the pandemic.
- Avoidance of unnecessary airway manipulation such as
bronchoscopy, trach changes, with a focus on a closed-circuit
ventilation, and utilizing ultrasound guidance for percutaneous
tracheostomy.