Department of Otolaryngology, Sydney Children's Hospital, Randwick, Australia.
School of Women and Children's Health, University of New South Wales Sydney, Australia.
J Laryngol Otol. 2022 Dec;136(12):1289-1295. doi: 10.1017/S0022215122001591. Epub 2022 Jul 5.
Paediatric patients with tracheostomies are a vulnerable group. During the coronavirus disease 2019 pandemic, healthcare workers can be anxious about viral transmission from secretions and aerosols emerging from the open airway. This paper aims to share a systematic approach to decrease staff exposure and optimise care of these patients.
Three documents were developed: a generic tracheostomy management plan detailing troubleshooting; a personalised management plan with customised recommendations; and a guide for tracheostomy tube change to minimise aerosol production.
The plan was distributed to 31 patients (age range, 11 months to 17 years) including 23 (74.2 per cent) with uncuffed tubes and 9 (29 per cent) on long-term ventilation. There have been 10 occasions in which the plan was utilised and influenced management.
A structured approach to emergency presentations during the coronavirus disease 2019 pandemic may safeguard paediatric patients from unnecessary manipulation of their tracheostomy tube, minimise viral exposure and allow provision of expeditious care.
小儿气管切开患者属于脆弱群体。在 2019 冠状病毒病大流行期间，医护人员可能会担心从开放气道中产生的分泌物和飞沫传播病毒。本文旨在分享一种系统的方法，以减少工作人员的暴露，并优化对这些患者的护理。
制定了三份文件：一份详细说明故障排除的通用气管切开管理计划；一份附有个性化建议的个性化管理计划；以及一份气管造口管更换指南，以尽量减少气溶胶的产生。
该计划分发给 31 名患者（年龄范围为 11 个月至 17 岁），其中 23 名（74.2%）患者使用无囊气管切开管，9 名（29%）患者长期通气。该计划共使用了 10 次，对管理产生了影响。
在 2019 冠状病毒病大流行期间，对紧急情况采取结构化的方法可以保护小儿患者的气管造口管免受不必要的操作，最大限度地减少病毒暴露，并允许迅速提供护理。
