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Emergency management plan for paediatric patients with tracheostomies during the coronavirus disease 2019 pandemic

Published online by Cambridge University Press:  05 July 2022

B Petulla ,
E Ho Open the ORCID record for E Ho [Opens in a new window] ,
E Sov  and
M Soma
B Petulla
Affiliation:
Department of Otolaryngology, Sydney Children's Hospital, Randwick, Australia
E Ho*
Affiliation:
Department of Otolaryngology, Sydney Children's Hospital, Randwick, Australia
E Sov
Affiliation:
Department of Otolaryngology, Sydney Children's Hospital, Randwick, Australia
M Soma
Affiliation:
Department of Otolaryngology, Sydney Children's Hospital, Randwick, Australia School of Women and Children's Health, University of New South Wales Sydney, Australia
*
Author for correspondence: Dr Emma Ho, Department of Otolaryngology, Sydney Children's Hospital, Randwick, Australia E-mail: Emma.loy.ho@gmail.com
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Abstract

Objectives

Paediatric patients with tracheostomies are a vulnerable group. During the coronavirus disease 2019 pandemic, healthcare workers can be anxious about viral transmission from secretions and aerosols emerging from the open airway. This paper aims to share a systematic approach to decrease staff exposure and optimise care of these patients.

Methods

Three documents were developed: a generic tracheostomy management plan detailing troubleshooting; a personalised management plan with customised recommendations; and a guide for tracheostomy tube change to minimise aerosol production.

Results

The plan was distributed to 31 patients (age range, 11 months to 17 years) including 23 (74.2 per cent) with uncuffed tubes and 9 (29 per cent) on long-term ventilation. There have been 10 occasions in which the plan was utilised and influenced management.

Conclusion

A structured approach to emergency presentations during the coronavirus disease 2019 pandemic may safeguard paediatric patients from unnecessary manipulation of their tracheostomy tube, minimise viral exposure and allow provision of expeditious care.

Keywords

COVID-19PediatricsTracheostomyRisk ManagementQuality Improvement
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 12 , December 2022 , pp. 1289 - 1295
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr E Ho takes responsibility for the integrity of the content of the paper

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