Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Otolaryngol Head Neck Surg. 2020 Jun;162(6):804-808. doi: 10.1177/0194599820919751. Epub 2020 Apr 14.
The novel coronavirus disease 2019 (COVID-19) pandemic has unfolded with remarkable speed, posing unprecedented challenges for health care systems and society. Otolaryngologists have a special role in responding to this crisis by virtue of expertise in airway management. Against the backdrop of nations struggling to contain the virus's spread and to manage hospital strain, otolaryngologists must partner with anesthesiologists and front-line health care teams to provide expert services in high-risk situations while reducing transmission. Airway management and airway endoscopy, whether awake or sedated, expose operators to infectious aerosols, posing risks to staff. This commentary provides background on the outbreak, highlights critical considerations around mitigating infectious aerosol contact, and outlines best practices for airway-related clinical decision making during the COVID-19 pandemic. What otolaryngologists need to know and what actions are required are considered alongside the implications of increasing demand for tracheostomy. Approaches to managing the airway are presented, emphasizing safety of patients and the health care team.
新型冠状病毒病 2019（COVID-19）大流行以惊人的速度展开，给医疗保健系统和社会带来了前所未有的挑战。耳鼻喉科医生在气道管理方面的专业知识使其在应对这一危机方面具有特殊作用。在各国努力遏制病毒传播和管理医院压力的背景下，耳鼻喉科医生必须与麻醉师和一线医疗团队合作，在高风险情况下提供专家服务，同时减少传播。气道管理和气道内镜检查，无论是清醒还是镇静，都会使操作人员接触到传染性气溶胶，从而使工作人员面临风险。本评论提供了疫情爆发的背景信息，重点介绍了减轻传染性气溶胶接触的关键注意事项，并概述了 COVID-19 大流行期间与气道相关的临床决策的最佳实践。还考虑了增加气管切开术需求的影响，探讨了耳鼻喉科医生需要了解的知识和所需的行动。提出了管理气道的方法，强调了患者和医疗团队的安全。
