Department of Respiratory Medicine, St George's University Hospital NHS Trust, London.
Department of ENT Surgery, St George's University Hospital NHS Trust, London.
Monaldi Arch Chest Dis. 2021 Dec 3;92(3). doi: 10.4081/monaldi.2021.2014.
The COVID-19 pandemic has resulted in a significant increase in the number of tracheostomised patients in hospitals requiring ventilatory support. These patients require highly specialist care, but overwhelmed hospital systems with stretched human resources potentially leave these patients cared for by undertrained healthcare professionals. We describe a rare complication where a routine COVID-19 swab done incorrectly via a tracheostomy tube, resulted in a snapped-off swab in the trachea. We outline the events and our method of removal using rigid bronchoscopy through the tracheostomy stoma as endo-tracheal bronchoscopy was impossible due to significant sub-glottic stenosis. This case highlights the paramount importance of the unique care needed to safely manage tracheostomies during this ongoing pandemic.
新冠疫情大流行导致医院中需要通气支持的气管切开患者数量显著增加。这些患者需要高度专业的护理，但医院系统不堪重负，人力资源紧张，可能导致这些患者由未经培训的医疗保健专业人员护理。我们描述了一种罕见的并发症，即在气管切开管中不正确地进行常规新冠拭子采样，导致拭子断裂在气管中。我们描述了事件经过和我们使用刚性支气管镜通过气管造口进行移除的方法，因为由于严重的声门下狭窄，经气管内支气管镜检查是不可能的。这个病例强调了在这场持续的大流行期间，安全管理气管切开术所需的特殊护理的至关重要性。
