Palas Anand, Raval Jayman, Aiyer R G, Arunlal Bhagyalakshmi
Department of E.N.T. and Head-Neck Surgery, Baroda Medical College and S.S.G. Hospital, Vadodara, Gujarat India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2809-2813. doi: 10.1007/s12070-020-02357-z. Epub 2021 Jan 4.
Our aim is to analyze effect of covid-19 pandemic in management of pediatric emergencies in E.N.T. and to provide recommendations for management of pediatric emergencies in E.N.T. during pandemic. In this retrospective study we included emergency pediatric cases required early intervention during covid-19 pandemic. Pre operative radiological investigation x-ray was done in all aero digestive foreign body patients. Pre operative HRCT neck and chest with virtual bronchoscopy in foreign body inhalation & compromised airway patients was done only in cases where patient's clinical condition was stable. Similarly RT PCR for covid-19 screening done only in cases where patient's clinical condition was stable. Adequate personal protective equipment was used during all the procedures. Total 29 Pediatric patients age ranging from 1 day to 13 years underwent procedures due to history of foreign body inhalation; ingestion, insertion and compromised airway in form of immediate endotracheal intubation were included. Comprehensively we recommend intervention only in emergency procedures during pandemic, use of personal protective equipment during all procedures, preoperative investigations for diagnosis and modifications in operation theatre, anesthesia and surgical techniques to reduce aerosols generation will minimize risk of infection transmission to health care workers.
我们的目的是分析新冠疫情对耳鼻喉科小儿急症管理的影响，并为疫情期间耳鼻喉科小儿急症的管理提供建议。在这项回顾性研究中，我们纳入了新冠疫情期间需要早期干预的小儿急症病例。所有气消化道异物患者均进行了术前放射学检查——X线检查。仅在患者临床状况稳定的情况下，对异物吸入及气道受损患者进行术前颈部和胸部高分辨率CT及虚拟支气管镜检查。同样，仅在患者临床状况稳定的情况下进行新冠病毒RT-PCR筛查。所有操作过程中均使用了足够的个人防护装备。共有29例年龄在1天至13岁之间的儿科患者因异物吸入史、吞食、插入以及以紧急气管插管形式出现的气道受损而接受了手术。我们全面建议，在疫情期间仅对紧急手术进行干预，在所有操作过程中使用个人防护装备，进行术前诊断检查，并对手术室、麻醉和手术技术进行改进以减少气溶胶产生，这样将最大限度地降低感染传播给医护人员的风险。
