Das Sauradeep, Thangavel Saranya, Raja Kalaiarasi, Saxena Sunil Kumar
Department of ENT, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pondicherry, 605006 India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):3098-3101. doi: 10.1007/s12070-021-02813-4. Epub 2021 Aug 22.
Foreign body of the trachea and the bronchus are critical emergencies which can lead to life threatening complications. But the advent of the 2019 novel corona virus disease, pandemic has dramatically changed the comfort of these procedures since aerosol generating medical procedures pose a risk and spread of infection to the health care workers. Even the patients are uncomfortable visiting the hospital due to the fear of acquiring the COVID infection.A 41-year-old obese female with grade 4 subglottic stenosis status post tracheostomy presented with foreign body Fuller's tracheostomy tube flange in the right bronchus during the COVID 19 pandemic. The patient had delayed presentation to the hospital due to fear of getting exposed to COVID and poor access to health care facilities due to lockdown imposed in various places in the nation. The patient was tested for COVID and taken up for surgery where rigid bronchoscopy and foreign body removal was done via the tracheostoma. The details of the procedure, challenges faced during the procedure, the effect of the COVID pandemic on the patients and hospital staffs are discussed. The complications of the broken tracheostomy tube can be most efficiently dispelled by proper tube care by the attenders and frequent tube change.
气管和支气管异物是严重的紧急情况，可导致危及生命的并发症。但自2019年新型冠状病毒病大流行以来，这些操作的便利性发生了巨大变化，因为产生气溶胶的医疗操作会给医护人员带来感染风险并造成感染传播。甚至患者也因担心感染新冠病毒而不愿前往医院就诊。一名41岁的肥胖女性，曾接受气管切开术，术后存在4级声门下狭窄，在新冠疫情期间，其右支气管出现了异物——富勒气管切开管凸缘。由于担心感染新冠病毒，且该国各地实施封锁导致医疗设施难以到达，该患者延迟就医。对该患者进行了新冠病毒检测，并接受了手术，通过气管造口进行了硬质支气管镜检查和异物取出。本文讨论了手术细节、手术过程中面临的挑战、新冠疫情对患者和医院工作人员的影响。妥善护理并频繁更换气管切开管，可最有效地消除气管切开管破裂的并发症。
