Tracheostomy and Personal Protective Equipment (PPE) in the midst of the COVID-19 Pandemic


Department ENT and Head Neck Surgery, Antwerp University Hospital, Antwerp, Belgium


Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium


Department of Otorhinolaryngology and Head and Neck Surgery, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium


Department of Otorhinolaryngology, University of Cagliari School of Medicine, Cagliari, Italy


Department of Otorhinolaryngology and Head and Neck Surgery, Universitair Ziekenhuis Brussel and Vrije Universitair Brussel, Brussels, Belgium


Central Manchester University Hospitals, University of Manchester, Manchester, UK

B-ENT 2020; 1: -
DOI: 10.5152/B-ENT.2020.20128
Read: 331 Downloads: 129 Published: 02 May 2020


The primary aim was to review the guidelines published by Otolaryngology Societies for performing tracheostomies in the COVID-19 pandemic. A secondary aim was to briefly review the literature for the effectiveness of surgical masks, N-95 and FFP-3 respirators, and power air purifying respirators (PAPRs) in reducing transmission of respiratory viral infections to health care workers while performing tracheostomy. Recommendations are mainly derived from clinical case series/retrospective observational studies from the SARS 2003/2004 outbreaks or experimental evidence for effectiveness for N-95/FFP-3 respirators and PAPRs. Differences do occur due to lack of evidence for COVID-19 as to whether N-95 and FFP-3 respirators are sufficient, or PAPRs should be recommended for tracheostomy. We would recommend adopting a conservative (protective) approach for HCWs teams performing tracheostomies, by routinely utilizing additional PPE such as PAPRs. Recommendations for the timing of tracheostomy also varied, however, almost all recommend a period of delay. The optimum duration of which is still unclear. 

Cite this article as: Faris C, Deben K, van Haesendonck G, et al. Making sense of personal protective equipment PPE and tracheostomy in the mists of the 2020 COVD-19 crisis. B-ENT 2 May 2020. 10.5152/B-ENT.2020.20128 [Epub Ahead of Print]

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