French consensus regarding precautions during tracheostomy and post-tracheostomy care in the context of COVID-19 pandemic
Identifieur interne : 000625 ( Main/Exploration ); précédent : 000624; suivant : 000626French consensus regarding precautions during tracheostomy and post-tracheostomy care in the context of COVID-19 pandemic
Auteurs : P. Schultz [France] ; J.-B. Morvan [France] ; N. Fakhry [France] ; S. Morinière [France] ; S. Vergez [France] ; C. Lacroix [France] ; S. Bartier [France] ; B. Barry [France] ; E. Babin [France] ; V. Couloigner [France] ; I. Atallah [France]Source :
- European Annals of Otorhinolaryngology, Head and Neck Diseases [ 1879-7296 ] ; 2020.
Abstract
Tracheostomy post-tracheostomy care are regarded as at high risk for contamination of health care professionals with the new coronavirus (SARS-CoV-2). Considering the rapid spread of the infection, all patients in France must be considered as potentially infected by the virus. Nevertheless, patients without clinical or radiological (CT scan) markers of COVID-19, and with negative nasopharyngeal sample within 24 h of surgery, are at low risk of being infected. Instructions for personal protection include specific wound dressings and decontamination of all material used. The operating room should be ventilated after each tracheostomy and the pressure of the room should be neutral or negative. Percutaneous tracheostomy is to be preferred over surgical cervicotomy in order to reduce aerosolization and to avoid moving patients from the intensive care unit to the operating room. Ventilation must be optimized during the procedure, to limit patient oxygen desaturation. Drug assisted neuromuscular blockage is advised to reduce coughing during tracheostomy tube insertion. An experienced team is mandatory to secure and accelerate the procedure as well as to reduce risk of contamination.
Url:
DOI: 10.1016/j.anorl.2020.04.006
PubMed: NONE
PubMed Central: 7144608
Affiliations:
- France
- Alsace (région administrative), Auvergne-Rhône-Alpes, Basse-Normandie, Centre-Val de Loire, Grand Est, Midi-Pyrénées, Occitanie (région administrative), Provence-Alpes-Côte d'Azur, Rhône-Alpes, Région Centre, Région Normandie, Île-de-France
- Caen, Créteil, La Tronche, Marseille, Paris, Strasbourg, Toulon, Toulouse, Tours
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Schultz</name><affiliation wicri:level="3"><nlm:aff id="aff0005">Service d’ORL et de chirurgie cervico-faciale, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d’ORL et de chirurgie cervico-faciale, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg</wicri:regionArea><placeName><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Morvan, J B" sort="Morvan, J B" uniqKey="Morvan J" first="J.-B." last="Morvan">J.-B. Morvan</name><affiliation wicri:level="3"><nlm:aff id="aff0010">Service d’ORL et de chirurgie cervico-faciale, hôpital d’instruction des armées Saint-Anne, 2, boulevard Sainte-Anne, 83000 Toulon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d’ORL et de chirurgie cervico-faciale, hôpital d’instruction des armées Saint-Anne, 2, boulevard Sainte-Anne, 83000 Toulon</wicri:regionArea><placeName><region type="region" nuts="2">Provence-Alpes-Côte d'Azur</region><settlement type="city">Toulon</settlement></placeName></affiliation></author><author><name sortKey="Fakhry, N" sort="Fakhry, N" uniqKey="Fakhry N" first="N." last="Fakhry">N. Fakhry</name><affiliation wicri:level="3"><nlm:aff id="aff0015">Service d’ORL et de chirurgie cervico-faciale, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d’ORL et de chirurgie cervico-faciale, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille</wicri:regionArea><placeName><region type="region" nuts="2">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Moriniere, S" sort="Moriniere, S" uniqKey="Moriniere S" first="S." last="Morinière">S. Morinière</name><affiliation wicri:level="3"><nlm:aff id="aff0020">Service d’ORL et de chirurgie cervico-faciale, CHRU Bretonneau-Tours, 2, boulevard Tonnellé, 37044 Tours, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d’ORL et de chirurgie cervico-faciale, CHRU Bretonneau-Tours, 2, boulevard Tonnellé, 37044 Tours</wicri:regionArea><placeName><region type="region" nuts="2">Centre-Val de Loire</region><region type="old region" nuts="2">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Vergez, S" sort="Vergez, S" uniqKey="Vergez S" first="S." last="Vergez">S. Vergez</name><affiliation wicri:level="3"><nlm:aff id="aff0025">Service d’ORL et de chirurgie cervico-faciale, CHU Rangueil-Larrey, 24, chemin de Pourvourville, 31400 Toulouse, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d’ORL et de chirurgie cervico-faciale, CHU Rangueil-Larrey, 24, chemin de Pourvourville, 31400 Toulouse</wicri:regionArea><placeName><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff0030">Service de chirurgie, Institut universitaire du cancer de Toulouse, 1, avenue Irène Joliot-Curie, 31100 Toulouse, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service de chirurgie, Institut universitaire du cancer de Toulouse, 1, avenue Irène Joliot-Curie, 31100 Toulouse</wicri:regionArea><placeName><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Lacroix, C" sort="Lacroix, C" uniqKey="Lacroix C" first="C." last="Lacroix">C. Lacroix</name><affiliation wicri:level="3"><nlm:aff id="aff0035">Service d’ORL et de chirurgie cervico-faciale, hôpital européen Georges-Pompidou, Assistance publique–Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d’ORL et de chirurgie cervico-faciale, hôpital européen Georges-Pompidou, Assistance publique–Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bartier, S" sort="Bartier, S" uniqKey="Bartier S" first="S." last="Bartier">S. Bartier</name><affiliation wicri:level="3"><nlm:aff id="aff0040">Service d’ORL et de chirurgie cervico-faciale, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94010 Créteil, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d’ORL et de chirurgie cervico-faciale, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94010 Créteil</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Créteil</settlement></placeName></affiliation></author><author><name sortKey="Barry, B" sort="Barry, B" uniqKey="Barry B" first="B." last="Barry">B. Barry</name><affiliation wicri:level="3"><nlm:aff id="aff0045">Service d’ORL et de chirurgie cervico-faciale, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d’ORL et de chirurgie cervico-faciale, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Babin, E" sort="Babin, E" uniqKey="Babin E" first="E." last="Babin">E. Babin</name><affiliation wicri:level="3"><nlm:aff id="aff0050">Service d’ORL et de chirurgie cervico-faciale, CHU Caen Normandie, avenue Côte de Nacre, 14000 Caen, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d’ORL et de chirurgie cervico-faciale, CHU Caen Normandie, avenue Côte de Nacre, 14000 Caen</wicri:regionArea><placeName><region type="region" nuts="2">Région Normandie</region><region type="old region" nuts="2">Basse-Normandie</region><settlement type="city">Caen</settlement></placeName></affiliation></author><author><name sortKey="Couloigner, V" sort="Couloigner, V" uniqKey="Couloigner V" first="V." last="Couloigner">V. Couloigner</name><affiliation wicri:level="3"><nlm:aff id="aff0055">Service d’ORL et de chirurgie cervico-faciale pédiatriques, hôpital Necker-Enfants–Malades, Assistance publique–Hôpitaux de Paris, 149, rue de Sèvres, 75743 Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d’ORL et de chirurgie cervico-faciale pédiatriques, hôpital Necker-Enfants–Malades, Assistance publique–Hôpitaux de Paris, 149, rue de Sèvres, 75743 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Atallah, I" sort="Atallah, I" uniqKey="Atallah I" first="I." last="Atallah">I. Atallah</name><affiliation wicri:level="3"><nlm:aff id="aff0060">Service d’ORL et de chirurgie cervico-faciale, CHU Grenoble Alpes, boulevard de la Chantourne, 38700 La Tronche, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d’ORL et de chirurgie cervico-faciale, CHU Grenoble Alpes, boulevard de la Chantourne, 38700 La Tronche</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region><settlement type="city">La Tronche</settlement></placeName></affiliation></author></analytic><series><title level="j">European Annals of Otorhinolaryngology, Head and Neck Diseases</title><idno type="ISSN">1879-7296</idno><idno type="eISSN">1879-730X</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Tracheostomy post-tracheostomy care are regarded as at high risk for contamination of health care professionals with the new coronavirus (SARS-CoV-2). Considering the rapid spread of the infection, all patients in France must be considered as potentially infected by the virus. Nevertheless, patients without clinical or radiological (CT scan) markers of COVID-19, and with negative nasopharyngeal sample within 24 h of surgery, are at low risk of being infected. Instructions for personal protection include specific wound dressings and decontamination of all material used. The operating room should be ventilated after each tracheostomy and the pressure of the room should be neutral or negative. Percutaneous tracheostomy is to be preferred over surgical cervicotomy in order to reduce aerosolization and to avoid moving patients from the intensive care unit to the operating room. Ventilation must be optimized during the procedure, to limit patient oxygen desaturation. Drug assisted neuromuscular blockage is advised to reduce coughing during tracheostomy tube insertion. An experienced team is mandatory to secure and accelerate the procedure as well as to reduce risk of contamination.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Wei, W I" uniqKey="Wei W">W.I. Wei</name></author><author><name sortKey="Tuen, H H" uniqKey="Tuen H">H.H. Tuen</name></author><author><name sortKey="Ng, R W" uniqKey="Ng R">R.W. Ng</name></author><author><name sortKey="Lam, L K" uniqKey="Lam L">L.K. Lam</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="To, K K W" uniqKey="To K">K.K.-W. To</name></author><author><name sortKey="Tsang, O T Y" uniqKey="Tsang O">O.T.-Y. Tsang</name></author><author><name sortKey="Leung, W S" uniqKey="Leung W">W.-S. Leung</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abe, T" uniqKey="Abe T">T. Abe</name></author><author><name sortKey="Madotto, T" uniqKey="Madotto T">T. Madotto</name></author><author><name sortKey="Pham, T" uniqKey="Pham T">T. Pham</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Phua, G C" uniqKey="Phua G">G.C. Phua</name></author><author><name sortKey="Govert, J" uniqKey="Govert J">J. Govert</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morvan, J B" uniqKey="Morvan J">J.B. Morvan</name></author><author><name sortKey="Pasquier, Y" uniqKey="Pasquier Y">Y. Pasquier</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>France</li></country><region><li>Alsace (région administrative)</li><li>Auvergne-Rhône-Alpes</li><li>Basse-Normandie</li><li>Centre-Val de Loire</li><li>Grand Est</li><li>Midi-Pyrénées</li><li>Occitanie (région administrative)</li><li>Provence-Alpes-Côte d'Azur</li><li>Rhône-Alpes</li><li>Région Centre</li><li>Région Normandie</li><li>Île-de-France</li></region><settlement><li>Caen</li><li>Créteil</li><li>La Tronche</li><li>Marseille</li><li>Paris</li><li>Strasbourg</li><li>Toulon</li><li>Toulouse</li><li>Tours</li></settlement></list><tree><country name="France"><region name="Grand Est"><name sortKey="Schultz, P" sort="Schultz, P" uniqKey="Schultz P" first="P." last="Schultz">P. Schultz</name></region><name sortKey="Atallah, I" sort="Atallah, I" uniqKey="Atallah I" first="I." last="Atallah">I. Atallah</name><name sortKey="Babin, E" sort="Babin, E" uniqKey="Babin E" first="E." last="Babin">E. Babin</name><name sortKey="Barry, B" sort="Barry, B" uniqKey="Barry B" first="B." last="Barry">B. Barry</name><name sortKey="Bartier, S" sort="Bartier, S" uniqKey="Bartier S" first="S." last="Bartier">S. Bartier</name><name sortKey="Couloigner, V" sort="Couloigner, V" uniqKey="Couloigner V" first="V." last="Couloigner">V. Couloigner</name><name sortKey="Fakhry, N" sort="Fakhry, N" uniqKey="Fakhry N" first="N." last="Fakhry">N. Fakhry</name><name sortKey="Lacroix, C" sort="Lacroix, C" uniqKey="Lacroix C" first="C." last="Lacroix">C. Lacroix</name><name sortKey="Moriniere, S" sort="Moriniere, S" uniqKey="Moriniere S" first="S." last="Morinière">S. Morinière</name><name sortKey="Morvan, J B" sort="Morvan, J B" uniqKey="Morvan J" first="J.-B." last="Morvan">J.-B. Morvan</name><name sortKey="Vergez, S" sort="Vergez, S" uniqKey="Vergez S" first="S." last="Vergez">S. Vergez</name><name sortKey="Vergez, S" sort="Vergez, S" uniqKey="Vergez S" first="S." last="Vergez">S. Vergez</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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